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改良Charlson合并症指数作为肝移植术后老年患者生存预测工具

Modified Charlson comorbidity index as a survival prediction tool for older patients after liver transplantation.

作者信息

Choi Jiho, Choi Eun-Woo, Choi YoungRok, Hong Su Young, Suh Sanggyun, Hong Kwangpyo, Han Eui Soo, Lee Jeong-Moo, Hong Suk Kyun, Yi Nam-Joon, Lee Kwang-Woong, Suh Kyung-Suk

机构信息

Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2023 Jun;104(6):358-363. doi: 10.4174/astr.2023.104.6.358. Epub 2023 Jun 7.

DOI:10.4174/astr.2023.104.6.358
PMID:37337600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10277175/
Abstract

PURPOSE

An increasing number of older patients now undergo liver transplantation (LT). Although the overall outcomes in older patients are not different from those of younger patients, there is no tool to predict LT prognosis in older patients. We hypothesized that a modified Charlson comorbidity index (mCCI) and 5-factor modified frailty index (mFI-5) can predict outcomes in older patients after LT.

METHODS

This retrospective study included 155 patients (aged >65 years) who underwent LT at Seoul National University Hospital. The recipients were subcategorized into 2 groups based on the mCCI score and mFI-5: the low (0-1) and high (2-5) mCCI groups, and low (≤0.4) and high (>0.4) mFI-5 groups. The independent effect of each variable on post-LT survival was determined using the mCCI subgroup, age at transplantation, sex, Child-Turcotte-Pugh score, model for end-stage liver disease (MELD) score, and mFI-5 subgroup.

RESULTS

The high-mCCI group (41 patients) showed significantly lower 1- and 3-month and 1-, 3-, and 5-year survival than the low-mCCI group. Using the Cox regression model, the mCCI, sex, and MELD score remained significant. The mFI-5 was not a significant factor to predict patients' survival.

CONCLUSION

The mCCI and MELD scores could be used to predict post-LT survival in older patients.

摘要

目的

现在越来越多的老年患者接受肝移植（LT）。尽管老年患者的总体预后与年轻患者并无差异，但尚无工具可预测老年患者的肝移植预后。我们假设改良的Charlson合并症指数（mCCI）和五因素改良衰弱指数（mFI-5）可以预测老年患者肝移植后的预后。

方法

这项回顾性研究纳入了155例在首尔国立大学医院接受肝移植的患者（年龄>65岁）。根据mCCI评分和mFI-5将受者分为两组：mCCI低分组（0-1）和高分组（2-5），以及mFI-5低分组（≤0.4）和高分组（>0.4）。使用mCCI亚组、移植时年龄、性别、Child-Turcotte-Pugh评分、终末期肝病模型（MELD）评分和mFI-5亚组确定每个变量对肝移植后生存的独立影响。

结果

高mCCI组（41例患者）的1个月、3个月以及1年、3年和5年生存率显著低于低mCCI组。使用Cox回归模型，mCCI、性别和MELD评分仍然具有显著性。mFI-5不是预测患者生存的显著因素。

结论

mCCI和MELD评分可用于预测老年患者肝移植后的生存情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/8e6b3196b033/astr-104-358-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/300eea6d0a9c/astr-104-358-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/b89dd34bb517/astr-104-358-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/80a46aaa0fe0/astr-104-358-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/8e6b3196b033/astr-104-358-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/300eea6d0a9c/astr-104-358-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/b89dd34bb517/astr-104-358-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/80a46aaa0fe0/astr-104-358-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d028/10277175/8e6b3196b033/astr-104-358-g004.jpg

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