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.
Abstract
We aimed to investigate the risk factors affecting the prognosis of patients with decompensated hepatitis B cirrhosis and their predictive values. The clinical data of 149 patients with decompensated hepatitis B cirrhosis, treated from August 2015 to June 2019, were analyzed retrospectively. They were divided into death and survival groups during a one-year follow-up. Their baseline data were compared, and the risk factors affecting death, correlations among risk factors, and predictive values of these factors for death were analyzed. Survival analysis was conducted. During a one-year follow-up, 103 patients survived, and 46 died. High neutrophil-lymphocyte ratio (NLR), red cell distribution width (RDW), the model for end-stage liver disease (MELD) score, the Child-Turcotte-Pugh (CTP) score, and low serum sodium were independent risk factors for death in patients with decompensated hepatitis B cirrhosis. NLR correlated positively with CTP and MELD scores (r=0.346, p=0.0001, r=0.243, p=0.0003, respectively). Likewise, the RDW had positive correlations with CTP and MELD scores (r=0.417, p=0.0001, r=0.413, p=0.0003, respectively). Serum sodium was negatively correlated with CTP and MELD scores (r=-0.484, p=0.0001, r=-0.476, p=0.0001, respectively). The survival rate was high in patients with NLR<7.38, RDW<16.15%, serum sodium>146.31 mmol/L, CTP score<10.26 points, and MELD score<11.31 points (p=0.0001). NLR, RDW, serum sodium, MELD, and CTP scores had high death predictive values. NLR, RDW, serum sodium, CTP score, and MELD score can be considered as critical indices for evaluating and predicting the prognosis of patients with decompensated hepatitis B cirrhosis.
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