Ma Bo, Shang Tianling, Huang Jianjie, Tu Zhixin, Wang Yan, Han Yujin, Wen Xiaoyu, Jin Qinglong
Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Med (Lausanne). 2022 Sep 6;9:904414. doi: 10.3389/fmed.2022.904414. eCollection 2022.
Hepatic Hydrothorax (HH) is one of the complications in patients with decompensated cirrhosis and its impact and role in the prognosis of patients with decompensated cirrhosis are not yet clear. Thus, this study aimed to determine the role of HH in patients with decompensated cirrhosis and the long-term impact on their mortality.
A retrospective study analyzed 624 patients with ascites without pleural effusion in decompensated cirrhosis and 113 patients with HH. Propensity scores were calculated based on eight variables, and the HH and non-HH groups were matched in a 1:1 ratio. The effect and role of HH on the prognosis of patients with decompensated cirrhosis was analyzed using the Kaplan-Meier method and Cox proportional hazards regression model.
A total of 737 patients were included. Out of 113 HH patients, 106 could be matched to 106 non-HH patients. After matching, baseline characteristics were well-balanced. The multifactorial Cox proportional hazards model indicated that hepatic encephalopathy and HH were independent risk factors affecting prognostic survival in patients with decompensated cirrhosis ( < 0.01), with risk ratios and 95% confidence intervals (CI) of 2.073 (95% CI: 1.229-3.494, < 0.01) and 4.724 (95% CI: 3.287-6.789, < 0.01), respectively. Prognostic survival was significantly worse in the HH group compared to patients in the non-HH group, with mortality rates of 17.9, 30.1, and 59.4% at 6 months, 1 year, and 2 years in the HH group, compared to 0.9, 3.8, and 5.6% in the non-HH group, respectively. The estimated median survival time was 21 (95% CI: 18-25) months in the HH group and 49 (95% CI: 46-52) months in the non-HH group ( < 0.001).
Hepatic hydrothorax is significantly associated with higher mortality in patients with decompensated cirrhosis and is a highly negligible independent decompensated event affecting their prognosis.
肝性胸水（HH）是失代偿期肝硬化患者的并发症之一，其在失代偿期肝硬化患者预后中的影响和作用尚不清楚。因此，本研究旨在确定HH在失代偿期肝硬化患者中的作用及其对患者死亡率的长期影响。
一项回顾性研究分析了624例失代偿期肝硬化腹水且无胸腔积液的患者和113例HH患者。基于八个变量计算倾向得分，HH组和非HH组按1:1比例进行匹配。采用Kaplan-Meier法和Cox比例风险回归模型分析HH对失代偿期肝硬化患者预后的影响和作用。
共纳入737例患者。113例HH患者中，106例可与106例非HH患者匹配。匹配后，基线特征均衡。多因素Cox比例风险模型表明，肝性脑病和HH是影响失代偿期肝硬化患者预后生存的独立危险因素（<0.01），风险比及95%置信区间（CI）分别为2.073（95%CI：1.229 - 3.494，<0.01）和4.724（95%CI：3.287 - 6.789，<0.01）。与非HH组患者相比，HH组的预后生存明显更差，HH组在6个月、1年和2年时的死亡率分别为17.9%、30.1%和59.4%，而非HH组分别为0.9%、3.8%和5.6%。HH组的估计中位生存时间为21（95%CI：18 - 25）个月，非HH组为49（95%CI：46 - 52）个月（<0.001）。
肝性胸水与失代偿期肝硬化患者的高死亡率显著相关，是影响其预后的一个高度不可忽视的独立失代偿事件。
