Establishment of a predictive model of death within 30 days for patients with liver cirrhosis and bacterial ascites / 临床肝胆病杂志

ABSTRACT

@#ObjectiveTo investigate the risk factors for death within 30 days in patients with liver cirrhosis and bacterial ascites, and to establish a predictive model of death within 30 days. MethodsA retrospective analysis was performed for the clinical data of 86 patients with liver cirrhosis and bacterial ascites who were admitted to Beijing Ditan Hospital, Capital Medical University, from January 2012 to April 2018. The patients were followed up for 30 days, and according to their prognosis, they were divided into survival group with 73 patients and death group with 13 patients. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate the influencing factors for death within 30 days in patients with liver cirrhosis and bacterial ascites, and a predictive model was established based on these influencing factors. The area under the receiver operating characteristic curve was used to evaluate the predictive value of each independent influencing factor and the predictive model. ResultsThe multivariate logistic regression analysis showed that there were significant differences between the survival group and the death group in ascites albumin (odds ratio ［OR］=0.615, 95% confidence interval ［CI］ 0.424-0.893, P=0.011), neutrophil-to-lymphocyte ratio (NLR) (OR=1.170, 95%CI 1.011-1.354, P=0.035), and Model for End-Stage Liver Disease (MELD) score (OR=1.341, 95% CI 1.111-1.618, P=0.002). A scoring model was established based on the results of the multivariate analysis to predict death within 30 days in patients with liver cirrhosis and bacterial ascites, and based on this model, the patients were divided into high-risk group with death within 30 days (score ≥2 points) and low-risk group with death within 30 days (score ＜2 points). There was a significant difference in mortality rate with 30 days between the two groups (60.0% vs 5.6%, P＜0.001). ConclusionAscites albumin ≤3.5 g/L, NLR ≥6.5, and MELD score ≥20 are independent risk factors for death within 30 days in patients with liver cirrhosis and bacterial ascites. The predictive model established on this basis can effectively evaluate the population at high risk of death within 30 days.