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肌酐修正的Pugh评分与Child-Pugh评分在失代偿期肝硬化预后评估中的比较

Comparison Between Creatinine-Modified Pugh Score and Child-Pugh Score for Prognostication in Decompensated Cirrhosis.

作者信息

Kumar Suraj, Shah Shobhit, Singh Balvir, Pradhan Akshyaya

机构信息

Cardiology, King George's Medical University, Lucknow, IND.

Medicine, Autonomous State Medical College, Firozabad, IND.

出版信息

Cureus. 2024 Jun 13;16(6):e62311. doi: 10.7759/cureus.62311. eCollection 2024 Jun.

Abstract

UNLABELLED

Introduction, aim, and objective: Despite recent evidence suggesting the blood creatinine level is a significant predictor of survival in liver cirrhosis patients, the conventional Child-Pugh (CP) score has held a longstanding position as a valuable prognostic indicator in cirrhotic individuals. This study aimed to compare the predictive capabilities of the modified CP score and the traditional CP score in decompensated cirrhosis patients to evaluate their prognostic power. The objective of this study was to assess the prognostic value of the modified and traditional CP scores in individuals with decompensated cirrhosis by assessing their predictive accuracy.

METHODS

A total of 100 patients diagnosed with decompensated cirrhosis participated in this prospective study. Each patient's Child-Pugh score and class were determined using admission data, with scores ranging from 5 to 15. Serum creatinine was incorporated as the sixth variable to compute the modified CP score, which ranges from 5 to 19.

RESULTS

The percentages of individuals aged 16-30, 31-40, 41-50, 51-60, and above 60 years were as follows: 16.0%, 29.0%, 26.0%, and 11.0%, respectively. The patients had a mean age of 44.71 years and a standard deviation of 13.40 years. Out of the 100 patients studied, 26% were female and 74% were male. Fifty-two percent of patients had mild hepatic encephalopathy, while 24% had moderate encephalopathy and 24% had severe encephalopathy. In cases of moderate and severe hepatic encephalopathy, the creatinine-modified Pugh score showed a considerably large area under the curve (AUC=0.852) on the receiver operating characteristics (ROC) curve.

CONCLUSION

When blood creatinine is taken into account, it can enhance the Child-Pugh classification's prognostic usefulness. This is especially true for patients with moderate to severe hepatic encephalopathy, where serum creatinine is a key factor in accurately predicting both survival and complications associated with cirrhosis.

摘要

未标注

引言、目的和目标:尽管最近有证据表明血肌酐水平是肝硬化患者生存的重要预测指标,但传统的Child-Pugh(CP)评分长期以来一直是肝硬化患者重要的预后指标。本研究旨在比较改良CP评分和传统CP评分在失代偿期肝硬化患者中的预测能力,以评估它们的预后价值。本研究的目的是通过评估改良和传统CP评分的预测准确性,来评估其在失代偿期肝硬化患者中的预后价值。

方法

共有100例诊断为失代偿期肝硬化的患者参与了这项前瞻性研究。根据入院数据确定每位患者的Child-Pugh评分和分级,评分范围为5至15分。将血清肌酐作为第六个变量纳入计算改良CP评分,其范围为5至19分。

结果

年龄在16 - 30岁、31 - 40岁、41 - 50岁、51 - 60岁和60岁以上的个体百分比分别为:16.0%、29.0%、26.0%、16.0%和11.0%。患者的平均年龄为44.71岁,标准差为13.40岁。在研究的100例患者中,26%为女性,74%为男性。52%的患者有轻度肝性脑病,24%有中度脑病,24%有重度脑病。在中度和重度肝性脑病病例中,肌酐改良的Pugh评分在受试者工作特征(ROC)曲线上显示出相当大的曲线下面积(AUC = 0.852)。

结论

当考虑血肌酐时,可以提高Child-Pugh分类的预后实用性。对于中度至重度肝性脑病患者尤其如此,其中血清肌酐是准确预测肝硬化相关生存和并发症的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1937/11246068/0d9d1da933b8/cureus-0016-00000062311-i01.jpg

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