Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model

doi:10.1111/j.1365-2893.2008.01046.x

科研成果详情

题名	Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model
作者	Sun Q.-F.1,7; Ding J.-G.1; Xu D.-Z.2; Chen Y.-P.3; Hong L.1; Ye Z.-Y.4; Zheng M.-H.3; Fu R.-Q.1; Wu J.-G.1; Du Q.-W.1; Chen W.1; Wang X.-F.1; Sheng J.-F.5,6
发表日期	2009-07
发表期刊	JOURNAL OF VIRAL HEPATITIS 影响因子和分区
语种	英语
原始文献类型	Article
关键词	acute-on-chronic liver failure hepatitis B model for end-stage liver disease prognosis
其他关键词	MELD ; TRANSPLANTATION ; MORTALITY ; SURVIVAL ; VIRUS ; EXPERIENCE ; MANAGEMENT ; ALLOCATION
摘要	The objective of this study was to determine the predictive value of the model for end-stage liver disease (MELD) scoring system in patients with acute-on-chronic hepatitis B liver failure (ACLF-HBV), and to establish a new model for predicting the prognosis of ACLF-HBV. A total of 204 adult patients with ACLF-HBV were retrospectively recruited between July 1, 2002 and December 31, 2004. The MELD scores were calculated according to the widely accepted formula. The 3-month mortality was calculated. The validity of the MELD model was determined by means of the concordance (c) statistic. Clinical data and biochemical values were included in the multivariate logistic regression analysis based on which the regression model for predicting prognosis was established. The receiver-operating characteristic curves were drawn for the MELD scoring system and the new regression model and the areas under the curves (AUC) were compared by the z-test. The 3-month mortality rate was 57.8%. The mean MELD score for the patients who died was significantly greater than those who survived beyond 3 months (28.7 vs 22.4, P = 0.003). The concordance (c) statistic (equivalent to the AUC) for the MELD scoring system predicting 3-month mortality was 0.709 (SE = 0.036, P < 0.001, 95% confidence interval 0.638-0.780). The independent factors predicting prognosis were hepatorenal syndrome (P < 0.001), liver cirrhosis (P = 0.009), HBeAg (P = 0.013), albumin (P = 0.028) and prothrombin activity (P = 0.011) as identified in multivariate logistic regression analysis. The regression model that was constructed by the logistic regression analysis produced a greater prognostic value (c = 0.891) than the MELD scoring system (z = 4.333, P < 0.001). The MELD scoring system is a promising and useful predictor for 3-month mortality of ACLF-HBV patients. Hepatorenal syndrome, liver cirrhosis, HBeAg, albumin and prothrombin activity are independent factors affecting the 3-month mortality. The newly established logistic regression model appears to be superior to the MELD scoring system in predicting 3-month mortality in patients with ACLF-HBV.
资助项目	Science Foundation from Sci-Tech Committee of Wenzhou City [Y20080186]
出版者	WILEY
出版地	HOBOKEN
ISSN	1352-0504
EISSN	1365-2893
卷号	16 期号:7 页码:464-470
DOI	10.1111/j.1365-2893.2008.01046.x
页数	7
WOS类目	Gastroenterology & Hepatology ; Infectious Diseases ; Virology
WOS研究方向	Gastroenterology & Hepatology ; Infectious Diseases ; Virology
WOS记录号	WOS:000266924200002
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	19413694
SCOPUSEID	2-s2.0-67650456412
通讯作者地址	[Sheng J.-F.]Department of Infectious Diseases,Zhejiang University,First Affiliated Hospital,79 Qingchun Road,China
Scopus学科分类	Hepatology;Infectious Diseases;Virology
引用统计	被引频次：70[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/10258
专题	其他_附属第三医院（瑞安市人民医院）附属第一医院第一临床医学院（信息与工程学院）、附属第一医院_内科学_感染内科
通讯作者	Sheng J.-F.
作者单位	1.Department of Infectious Diseases,Third Affiliated Hospital,Wenzhou Medical College,China; 2.Department of Infectious Diseases,Beijing Ditan Hospital,China; 3.Department of Infection and Liver Diseases,First Affiliated Hospital,Wenzhou Medical College,China; 4.Centeral Blood Station of Wenzhou,China; 5.Department of Infectious Diseases,Zhejiang University,First Affiliated Hospital,China; 6.Department of Infectious Diseases,Zhejiang University,First Affiliated Hospital,79 Qingchun Road,China; 7.Department of Infectious Diseases,Third Affiliated Hospital,Wen-zhou Medical College,108 Wan song Road,China
第一作者单位	附属第三医院（瑞安市人民医院）
第一作者的第一单位	附属第三医院（瑞安市人民医院）
推荐引用方式 GB/T 7714	Sun Q.-F.,Ding J.-G.,Xu D.-Z.,et al. Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model[J]. JOURNAL OF VIRAL HEPATITIS,2009,16(7):464-470.
APA	Sun Q.-F.., Ding J.-G.., Xu D.-Z.., Chen Y.-P.., Hong L.., ... & Sheng J.-F.. (2009). Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model. JOURNAL OF VIRAL HEPATITIS, 16(7), 464-470.
MLA	Sun Q.-F.,et al."Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model".JOURNAL OF VIRAL HEPATITIS 16.7(2009):464-470.