Dejanović Božidar, Barak Otto, Čolović Petar, Janjić Nebojša, Savić Željka, Gvozdanović Nikola, Ružić Maja
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Clinic of Gastroenterology and Hepatology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia.
J Clin Med. 2024 Oct 18;13(20):6208. doi: 10.3390/jcm13206208.
: There is a strong correlation between systemic inflammation intensity and clinical presentation, disease progression, and survival during liver cirrhosis decompensation. This study aimed to evaluate the prognostic performance of blood-based biomarkers as meta-inflammation markers, including NLR, PLR, LMR, INPR, MPR, ALBI, FIB4, and APRI, in predicting hospital mortality in patients with acute decompensation of alcohol-related liver cirrhosis. : Data from 411 patients with their first onset of acute decompensation were analyzed, forming two groups: deceased and survived during hospitalization. Generalized partial least squares regression analysis was applied to explore the effects of surrogate indicators on mortality rates, using mortality rate as the dependent variable. Root Mean Square Error, Akaike's, and Bayesian information criteria determined that four components accounted for most of the variance. : Variables with significant negative contributions to the outcome prediction (ranked by standardized regression coefficients) were encephalopathy grade, total bilirubin, Child-Turcotte-Pugh score, MELD, NLR, MPV, FIB4, INR, PLR, and ALT. Coefficient sizes ranged from -0.63 to -0.09, with -values from 0 to 0.018. : NLR, PLR, and FIB4 significantly contribute to hospital mortality prediction in patients with acute decompensation of alcohol-related liver cirrhosis. Conversely, some variables used to predict liver disease severity, including INPR, APRI, LMR, and ALBI score, did not significantly contribute to hospital mortality prediction in this patient population.
全身炎症强度与肝硬化失代偿期的临床表现、疾病进展及生存率之间存在密切关联。本研究旨在评估基于血液的生物标志物作为元炎症标志物(包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、国际标准化比值(INR)、平均血小板体积(MPV)、白蛋白-胆红素(ALBI)分级、FIB-4指数及终末期肝病模型(APRI))在预测酒精性肝硬化急性失代偿患者院内死亡率方面的预后性能。
分析了411例首次发生急性失代偿的患者的数据,将其分为两组:住院期间死亡组和存活组。采用广义偏最小二乘回归分析,以死亡率为因变量,探讨替代指标对死亡率的影响。均方根误差、赤池信息准则和贝叶斯信息准则确定四个成分占大部分方差。
对结局预测有显著负贡献的变量(按标准化回归系数排序)为肝性脑病分级、总胆红素、Child-Turcotte-Pugh评分、终末期肝病模型(MELD)、中性粒细胞与淋巴细胞比值(NLR)、平均血小板体积(MPV)、FIB-4指数、国际标准化比值(INR)、血小板与淋巴细胞比值(PLR)及谷丙转氨酶(ALT)。系数大小范围为-0.63至-0.09,P值范围为0至0.018。
中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及FIB-4指数对酒精性肝硬化急性失代偿患者的院内死亡率预测有显著贡献。相反,一些用于预测肝病严重程度的变量,包括国际标准化比值(INR)、终末期肝病模型(APRI)、淋巴细胞与单核细胞比值(LMR)及白蛋白-胆红素(ALBI)分级,对该患者群体的院内死亡率预测无显著贡献。