Yan Libo, Yuan Man, Su Mao, Cui Kunping, Teng Xiangnan, Yuan Fang, Bai Lang
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
J Viral Hepat. 2025 Oct;32(10):e70076. doi: 10.1111/jvh.70076.
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition with high short-term mortality, making early prognosis crucial. The liver-to-spleen volume ratio (LSVR) provides important prognostic information but is not included in current tools. This study evaluated the link between LSVR from computed tomography and short-term mortality in HBV-ACLF patients. The study included 278 patients, divided into five groups based on LSVR quintiles. The main outcome was 28-day mortality, with a secondary focus on 90-day mortality. Multivariable Cox regression and restricted cubic splines were used to analyse the LSVR-mortality relationship. Participants had a mean age of 48 years, 82.7% were male, with 28- and 90-day mortality rates of 23.4% and 31.3%, respectively. After adjusting for covariates, the risk of 28-day mortality was elevated by 553% (OR 6.53, 95% CI 1.86-23) in the highest quintile of LSVR (Q5 ≥ 3.6) and by 343% (OR 4.43, 95% CI 1.14-17.16) in the lowest quintile (Q1 ≤ 1.6), as compared to the reference quintile (Q3 2.4-2.9). The curve-fitting results showed a U-shaped relationship between LSVR and the risk of 28-day mortality and 90-day mortality, with an infection point of 2.7. There is a U-shaped relationship between LSVR and mortality in HBV-ACLF patients. Higher or lower LSVR is associated with an increased risk of short-term mortality in HBV-ACLF patients.
