Sheng Yunjian, Zeng Yu, Luo Wenling, Zhang Xuemei, Wang Hang, Jiao Jiahuan
Department of Infectious Diseases, the Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China.
Department of Gastroenterology, Dazhou Hospital of Integrated Traditional and Western Medicine, Dazhou, Sichuan, People's Republic of China.
Int J Gen Med. 2023 Oct 6;16:4565-4572. doi: 10.2147/IJGM.S434572. eCollection 2023.
Acute-on-chronic liver failure is a common clinical syndrome with high short-term mortality, and early assessment of its mortality risk is crucial, but the search for valid and accurate prognostic biomarkers is a challenging endeavor. The purpose of this study was to investigate the predictive value of the prothrombin time-international normalized ratio to albumin ratio (PTAR) for mortality in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).
A total of 354 patients with HBV-ACLF were included in the retrospective study. Patients were divided into survival and non-survival groups based on 90-day follow-up. Cox regression analysis was used to explore the relationship between PTAR and 90-day mortality in patients with HBV-ACLF. The area under the receiver operating characteristic curve was used to evaluate the effectiveness of PTAR in predicting mortality.
PTAR was significantly higher in non-survivors than in survivors. The results of multivariate analysis showed that PTAR was a valid independent predictor of mortality in patients with HBV-ACLF. Its predictive ability for mortality was similar to that of the Child-Turcotte-Pugh score, the end-stage liver disease model (MELD) score, and the MELD-sodium score.
PTAR may be a simple and effective tool for predicting the prognosis of patients with HBV-ACLF.
慢加急性肝衰竭是一种常见的临床综合征，短期死亡率高，早期评估其死亡风险至关重要，但寻找有效且准确的预后生物标志物是一项具有挑战性的工作。本研究的目的是探讨凝血酶原时间-国际标准化比值与白蛋白比值（PTAR）对乙型肝炎病毒相关慢加急性肝衰竭（HBV-ACLF）患者死亡率的预测价值。
本回顾性研究共纳入354例HBV-ACLF患者。根据90天随访结果将患者分为生存组和非生存组。采用Cox回归分析探讨PTAR与HBV-ACLF患者90天死亡率之间的关系。采用受试者工作特征曲线下面积评估PTAR预测死亡率的有效性。
非幸存者的PTAR显著高于幸存者。多因素分析结果显示，PTAR是HBV-ACLF患者死亡率的有效独立预测因子。其对死亡率的预测能力与Child-Turcotte-Pugh评分、终末期肝病模型（MELD）评分和MELD-钠评分相似。
PTAR可能是预测HBV-ACLF患者预后的一种简单有效的工具。
