Zhang Yue, Chen Peng, Zhang Wang, Huang Chenkai, Zhu Xuan
Department of Gastroenterology, Jiangxi Province and Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Patient Prefer Adherence. 2023 May 19;17:1293-1302. doi: 10.2147/PPA.S412063. eCollection 2023.
Acute decompensated cirrhosis (AD) is related to high medical costs and high mortality. We recently proposed a new score model to predict the outcome of AD patients and compared it with the common score model (CTP, MELD and CLIF-C AD score) in the training and validation sets.
A total of 703 patients with AD were enrolled from The First Affiliated Hospital of Nanchang University between December 2018 and May 2021. These patients were randomly assigned to the training set (n=528) and validation set (n=175). Risk factors affecting prognosis were identified by Cox regression analysis and then used to establish a new score model. The prognostic value was determined by the area under the receiver operating characteristic curve (AUROC).
A total of 192 (36.3%) patients in the training cohort and 51 (29.1%) patients in the validation cohort died over the course of 6 months. A new score model was developed with predictors including age, bilirubin, INR, WBC, albumin, ALT and BUN. The new prognostic score (0.022×Age + 0.003×TBil + 0.397×INR + 0.023×WBC- 0.07×albumin + 0.001×ALT + 0.038×BUN) for long-term mortality was superior to three other scores based on both training and internal validation studies.
This new score model appears to be a valid tool for assessing the long-term survival of AD patients, improving the prognostic value compared with the CTP, MELD and CLIF-C AD scores.
急性失代偿性肝硬化（AD）与高昂的医疗费用和高死亡率相关。我们最近提出了一种新的评分模型来预测AD患者的预后，并在训练集和验证集中将其与常用评分模型（CTP、MELD和CLIF-C AD评分）进行比较。
2018年12月至2021年5月期间，从南昌大学第一附属医院招募了703例AD患者。这些患者被随机分配到训练集（n = 528）和验证集（n = 175）。通过Cox回归分析确定影响预后的危险因素，然后用于建立新的评分模型。通过受试者操作特征曲线下面积（AUROC）确定预后价值。
在6个月的病程中，训练队列中有192例（36.3%）患者死亡，验证队列中有51例（29.1%）患者死亡。开发了一种新的评分模型，其预测因素包括年龄、胆红素、国际标准化比值（INR）、白细胞（WBC）、白蛋白、谷丙转氨酶（ALT）和尿素氮（BUN）。基于训练和内部验证研究，用于预测长期死亡率的新预后评分（0.022×年龄 + 0.003×总胆红素 + 0.397×INR + 0.023×WBC - 0.07×白蛋白 + 0.001×ALT + 0.038×BUN）优于其他三种评分。
这种新的评分模型似乎是评估AD患者长期生存的有效工具，与CTP、MELD和CLIF-C AD评分相比，其预后价值有所提高。
