Risk factors for the prognosis of patients with decompensated hepatitis B cirrhosis and their predictive values.

Factores de riesgo para el pronóstico de pacientes con cirrosis por hepatitis B descompensada y sus valores predictivos.

• Li Li The First People’s Hospital of Fuyang District, Hangzhou, Zhejiang Province, China. https://orcid.org/0000-0002-8278-638X
• Jihui Zhang Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. https://orcid.org/0000-0001-9251-7047
• Peng Yuan General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. https://orcid.org/0000-0002-4305-6499
• Jianjun Song General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. https://orcid.org/0000-0003-0401-3936
• Zhenhui Lu General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. https://orcid.org/0000-0002-8983-7901
• Guozhong Zhao General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. https://orcid.org/0000-0001-6218-0973

DOI: https://doi.org/10.54817/IC.v64n2a06

Palabras clave: cirrosis por hepatitis b descompensada, pronóstico, factor de riesgo, valor predictivo

Resumen

Nuestro objetivo fue investigar los factores de riesgo que afectan el pronóstico de los pacientes con cirrosis por hepatitis B descompensada y sus valores predictivos. Se analizaron retrospectivamente los datos clínicos de 149 pacientes con cirrosis por hepatitis B descompensada tratados desde agosto de 2015 hasta junio de 2019. Estos pacientes se dividieron en grupos de muerte y supervivencia, durante un año de seguimiento. Se compararon sus datos basales de referencia y se analizaron los factores de riesgo que afectan la muerte, las correlaciones entre los factores de riesgo y los valores predictivos de muerte de estos factores. El análisis de supervivencia durante un año de seguimiento, demostró que sobrevivieron 103 pacientes y fallecieron 46. La alta proporción de neutrófilos-linfocitos (NLR), el ancho de distribución de glóbulos rojos (RDW), el modelo para la puntuación de enfermedad hepática en etapa terminal (MELD), la puntuación de Child-Turcotte-Pugh (CTP) y el bajo nivel de sodio sérico fueron factores de riesgo independientes para la muerte en pacientes con cirrosis por hepatitis B descompensada. NLR tuvo correlaciones positivas con la puntuación CTP y la puntuación MELD (r = 0,346, p = 0,0001, r = 0,243, p = 0,0003, respectivamente). RDW tuvo correlaciones positivas con la puntuación CTP y la puntuación MELD (r = 0,417, p = 0,0001, r = 0,413, p = 0,0003, respectivamente). El sodio sérico se correlacionó negativamente con las puntuaciones CTP y MELD (r=-0,484, p=0,0001, r=-0,476, p=0,0001, respectivamente). La tasa de supervivencia fue alta en pacientes con NLR <7,38, RDW <16,15%, sodio sérico> 146,31 mmol/L, puntuación CTP <10,26 puntos y puntuación MELD <11,31 puntos (p = 0,0001). NLR, RDW, sodio sérico, puntaje MELD y puntaje CTP tuvieron altos valores predictivos de muerte. NLR, RDW, sodio sérico, puntaje CTP y puntaje MELD pueden considerarse índices importantes para evaluar y predecir el pronóstico de pacientes con cirrosis por hepatitis B descompensada.

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