Faivre J, Milan C, Joyeux J, Martin F, Dusserre L, Klepping C
Pathol Biol (Paris). 1981 Sep;29(7):399-404.
In order to define immediate criteria of prognosis for patients with cirrhosis, hospitalized in emergency for upper gastrointestinal tract haemorrhage, 164 cases of haemorrhages medically treated were reviewed. A prognostic study of each variant points to the clinical endoscopic and biological data connected with death. That study illustrates the prognostic value of traditional data. Patients who died within the first 30 days had a significantly higher incidence of hepatic encephalopathy, hematemesis, ascites, low blood pressure, bleeding oesophageal varices during endoscopy,. hypoprothrombinemia, hyperbilirubinemia. Those who survived had a significantly higher incidence of aspirin intake, numerous haemorrhages, good state of health, non bleeding peptic ulcer. Several series of multivariant analysis : multiple regression and linear discrimination, differing from one another in variates were done. They have allowed identification of 11 variables used in establishing a prognostic index. In the series, it gives an 87% probability of correct differentiation. Such an index allows an objective estimate of the value and limits of a group of patients in which the efficiency of other treatments could be tested in controlled trials.
为了确定因上消化道出血而急诊住院的肝硬化患者的近期预后标准,我们回顾了164例接受内科治疗的出血病例。对每个变量的预后研究指向与死亡相关的临床、内镜和生物学数据。该研究阐明了传统数据的预后价值。在最初30天内死亡的患者,肝性脑病、呕血、腹水、低血压、内镜检查时食管静脉曲张出血、低凝血酶原血症、高胆红素血症的发生率显著更高。存活的患者阿司匹林摄入、多次出血、健康状况良好、非出血性消化性溃疡的发生率显著更高。进行了几组多变量分析:多元回归和线性判别,变量各不相同。它们使得能够识别用于建立预后指数的11个变量。在该系列中,其正确区分的概率为87%。这样一个指数能够客观评估一组患者的价值和局限性,在这些患者中可以在对照试验中测试其他治疗方法的疗效。