Glisic Tijana, Popovic Dusan D, Lolic Iva, Toplicanin Aleksandar, Jankovic Katarina, Dragasevic Sanja, Aleksic Marko, Stjepanovic Mihailo, Oluic Branislav, Matovic Zaric Vera, Radisavljevic Mirjana M, Stojkovic Lalosevic Milica
Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
J Clin Med. 2023 Jul 21;12(14):4820. doi: 10.3390/jcm12144820.
Liver cirrhosis is the final stage of chronic liver disease. We aimed to evaluate non-invasive scores as predictors of complications and outcome in cirrhotic patients.
A total of 150 cirrhotic patients were included. Models for end-stage liver disease (MELD), albumin-bilirubin (ALBI) score, neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MoLR), and neutrophil-lymphocyte-albumin ratio (NLA) scores were tested in relation to the development of complications and mortality using receiver operating characteristic (ROC) curves.
The ROC curve analysis showed (area under the curve) AUC values of NLR, NLA, ALBI, and MELD of 0.711, 0.730, 0.627, and 0.684, respectively, for short-term mortality. MELD, ALBI, and NLA scores showed a statistically significant correlation with hepatic encephalopathy ( = 0.000 vs. 0.014 vs. 0.040, respectively), and the MELD cut-off value of 16 had a sensitivity of 70% and a specificity of 52% (AUC: 0.671, 95% CI (0.577-0.765)). For the assessment of the presence of ascites, the AUC values for NLA and MoLR were 0.583 and 0.658, respectively, with cut-offs of 11.38 and 0.44.
MELD, ALBI, and NLA are reliable predictors of hepatic encephalopathy. NLA and MoLR showed a significant correlation with the presence of ascites, and MELD, ALBI, NLR, and NLA have prognostic value to predict 30-day mortality in cirrhotic patients.
肝硬化是慢性肝病的终末期。我们旨在评估非侵入性评分作为肝硬化患者并发症和预后的预测指标。
共纳入150例肝硬化患者。使用受试者工作特征（ROC）曲线，对终末期肝病模型（MELD）、白蛋白-胆红素（ALBI）评分、中性粒细胞-淋巴细胞比值（NLR）、单核细胞-淋巴细胞比值（MoLR）和中性粒细胞-淋巴细胞-白蛋白比值（NLA）评分与并发症发生情况和死亡率之间的关系进行了测试。
ROC曲线分析显示，短期死亡率方面，NLR、NLA、ALBI和MELD的曲线下面积（AUC）值分别为0.711、0.730、0.627和0.684。MELD、ALBI和NLA评分与肝性脑病呈显著统计学相关性（分别为=0.000对0.014对0.040），MELD临界值为16时，敏感性为70%，特异性为52%（AUC：0.671，95%CI（0.577 - 0.765））。对于腹水存在情况的评估，NLA和MoLR的AUC值分别为0.583和0.658，临界值分别为11.38和0.44。
MELD、ALBI和NLA是肝性脑病的可靠预测指标。NLA和MoLR与腹水的存在显著相关，MELD、ALBI、NLR和NLA对预测肝硬化患者30天死亡率具有预后价值。
