Liver failure staging and MELD predicted the short term prognosis of HBV-acute-on-chronic liver failure / 重庆医学

ABSTRACT

Objective To study the clinical significance of liver failure staging and MELD in predicting the short term prognosis of HBV-acute-on-chronic liver failure (HBV-ACLF).Methods One hundred and ten HBV-ACLF patients admitted to our hospital from July 2013 to July 2015 were included into this study.They were divided into early stage group (n=18),middle stage group (n=48) and end stage group (n=44),the fatality rate in each group was evaluated.According to the MELD score at baseline,they were divided into four groups,MELD＜20 (n =24),20≤ MELD＜30 (n=54),30≤MELD＜40(n =28),40≤MELD (n =4).The fatality rate in each group was evaluated.In the middle stage group,they were be divided into two groups,/△MELD＜0 and △MELD＞0(△MELD=MELD1w-MELDbaseline).The fatality rate in each group was evaluated.Results The fatality rate of the 3 groups(Early,Middle and End stage group) at 3th month was 0,50％,95 ％ respectively(P＜ 0.05).The fatality rate of the 4 groups (MELD＜20,20≤MELD＜30,30≤MELD＜40,40≤MELD)was 31.58％,66.67％,85.71％ and 100％ respectively (P＜ 0.05).In the middle stage group,the fatality rate of the two groups was (△MELD＜0 and △MELD＞ 0)41.18％ and 85.71％ (P=0.001).Conclusion It can be shown that the survival probability of early stage group was high,the probability of death in end stage group and middle stage group with△MELD＞0 was high.