Carteri Randhall B, Marroni Claudio A, Ferreira Luis F, Pinto Letícia P, Czermainski Juliana, Tovo Cristiane V, Fernandes Sabrina A
Department of Nutrition, Centro Universitário CESUCA, Cachoeirinha 94935-630, Brazil.
Postgraduate in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, Brazil.
World J Hepatol. 2025 Jan 27;17(1):99183. doi: 10.4254/wjh.v17.i1.99183.
Cirrhotic patients face heightened energy demands, leading to rapid glycogen depletion, protein degradation, oxidative stress, and inflammation, which drive disease progression and complications. These disruptions cause cellular damage and parenchymal changes, resulting in vascular alterations, portal hypertension, and liver dysfunction, significantly affecting patient prognosis.
To analyze the association between Child-Turcotte-Pugh (CTP) scores and different nutritional indicators with survival in a 15-year follow-up cohort.
This was a retrospective cohort study with 129 cirrhotic patients of both sexes aged > 18 years. Diagnosis of cirrhosis was made by liver biopsy. The first year of data collection was 2007, and data regarding outcomes were collected in 2023. Data were gathered from medical records, and grouped by different methods, including CTP, handgrip strength, and triceps skinfold cutoffs. The prognostic values for mortality were assessed using Kaplan-Meier curves and multivariate binary logistic regression models.
The coefficient for CTP was the only statistically significant variable (Wald = 5.193, = 0.023). This suggests that with a negative change in CTP classification score, the odds of survival decrease 52.6%. The other evaluated variables did not significantly predict survival outcomes in the model. Kaplan-Meier survival curves also indicated that CTP classification was the only significant predictor.
Although different classifications showed specific differences in stratification, only CTP showed significant predictive potential. CTP score remains a simple and effective predictive tool for cirrhotic patients even after longer follow-up.
肝硬化患者面临更高的能量需求，导致糖原迅速消耗、蛋白质降解、氧化应激和炎症，这些因素推动疾病进展和并发症的发生。这些紊乱会导致细胞损伤和实质改变，进而引起血管改变、门静脉高压和肝功能障碍，显著影响患者预后。
分析在一个15年随访队列中，Child-Turcotte-Pugh（CTP）评分和不同营养指标与生存率之间的关联。
这是一项回顾性队列研究，纳入了129名年龄大于18岁的男女肝硬化患者。通过肝活检确诊肝硬化。数据收集的第一年为2007年，结局数据于2023年收集。数据从医疗记录中获取，并按不同方法分组，包括CTP、握力和肱三头肌皮褶厚度临界值。使用Kaplan-Meier曲线和多变量二元逻辑回归模型评估死亡率的预后价值。
CTP系数是唯一具有统计学意义的变量（Wald = 5.193，P = 0.023）。这表明CTP分类评分出现负向变化时，生存几率降低52.6%。模型中其他评估变量未显著预测生存结局。Kaplan-Meier生存曲线也表明CTP分类是唯一显著的预测因素。
尽管不同分类在分层方面存在特定差异，但只有CTP显示出显著的预测潜力。即使经过更长时间的随访，CTP评分仍然是肝硬化患者简单有效的预测工具。
