ABSTRACT
Objective:To study the factors influencing short-term prognosis of patients with Budd-Chiari syndrome (B-CS) presenting with upper gastrointestinal bleeding and to assess the predictive value of platelet-albumin-bilirubin score (PALBI) on death within 30 d in these patients.Methods:A retrospective study was conducted on 74 patients with B-CS who presented with upper gastrointestinal bleeding and were treated at the First Affiliated Hospital of Zhengzhou University from January 2014 to February 2020. There were 51 males and 23 females, with age of (46.5±11.1) years old. These patients were divided into the survival group ( n=58) and the death group ( n=16) according to the disease outcomes up to 30 d of follow-up. Factors influencing short-term deaths of these patients were analyzed, and the predictive values of PALBI, ALBI, CTP and MELD scores on short-term prognosis of the patients were assessed. The receiver operating characteristic (ROC) curves were plotted, and the areas under the curve (AUC) were calculated and compared. Results:The differences between patients in the survival and death groups for white blood cell, platelet, PALBI score, PALBI classification, ALBI score, CTP score, MELD score, and presence or absence of hepatic encephalopathy were significantly different (all P<0.05). Multivariate logistic regression analysis showed that CTP score≥10 or CTP grade C ( OR=1.669, 95% CI: 1.048-2.661), and PALBI score >-2.09 or PALBI grade 3 ( OR=5.245, 95% CI: 2.128-12.924) were independent risk factors for predicting death within 30 days. The areas under the ROC curves for PALBI, ALBI, CTP and MELD score were 0.89, 0.72, 0.77 and 0.76, with the cut-off values of -1.92, -1.60, 8.50 and 13.60, respectively. The differences between the PALBI score and ALBI, CTP scores were significantly different ( P<0.05). Conclusion:The PALBI score showed a positive predictive value on short-term prognostic assessment of patients with B-CS presenting with upper gastrointestinal bleeding. It was comparable to the effect of the MELD score but was significantly better than the ALBI and CTP scores.
ABSTRACT
ObjectiveTo investigate the value of platelet-albumin-bilirubin score (PALBI) in predicting the 30-day mortality of patients with liver cirrhosis and acute upper gastrointestinal bleeding (AUGIB). MethodsA retrospective analysis was performed for the clinical data of 211 patients with liver cirrhosis who were admitted to Jinshan Hospital of Fudan University due to AUGIB from January 2016 to February 2020, and according to the survival status within 30 days, they were divided into death group with 24 patients and survival group with 187 patients. Epidemiological data (including age and sex) and laboratory examination results (including routine blood test results, hepatic and renal function, and coagulation function) were collected, and the scores of PALBI, albumin-bilirubin (ALBI), Child-Turcotte-Pugh (CTP), and Model for End-Stage Liver Disease (MELD) on admission were calculated and compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. With the application of 95% confidence interval, the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the predictive ability of the model. The DeLong test was used for comparison of ROC curve. ResultsCompared with the survival group, the death group had significantly higher PALBI score (-1.47±0.35 vs -1.94±0.36, P＜0.001), ALBI score (-0.74±0.49 vs -1.38±0.51, P＜0.001), CTP score (10.25±1.98 vs 8.06±1.70, P＜0.001), and MELD score (17.25±4.68 vs 11.63±4.83, P＜0.001). PALBI, ALBI, CTP, and MELD scores had an AUC of 0.827, 0.824, 0.790, and 0811, respectively, and there was no significant difference in AUC between any two scores (P＞0.05). ConclusionPALBI score has good performance in predicting the 30-day mortality of patients with liver cirrhosis and AUGIB and is comparable to CTP and MELD scores.