Clinical Significance of CONUT Combined With CTP Score in Predicting Short-term Prognosis of Patients With Liver Cirrhosis Complicated With Hepatic Encephalopathy / 胃肠病学

ABSTRACT

Background: Hepatic encephalopathy (HE) is one of the main causes of death in patients with end-stage liver disease. Early evaluation of the condition of patients with liver cirrhosis complicated with HE is the key for improving the prognosis. Aims: To investigate the effects of controlling nutritional status (CONUT) and CTP score on predicting the short term prognosis of liver cirrhosis patients complicated with HE. Methods: The clinical data of 168 liver cirrhosis patients complicated with HE initially diagnosed in Nantong Third People's Hospital from January 2018 to December 2021 were enrolled and analyzed retrospectively. HE patients were divided into survival group and death group. Cox regression analysis was used to evaluate the risk factors affecting the prognosis. A new prediction model was established, and ROC curve was used to evaluate the values of different models for short⁃term prognosis of HE patients. Survival was evaluated by Kaplan⁃Meier method. Results: Compared with survival group, ALT, AST, TBIL, INR, white blood cell count, neutrophil were significantly increased in death group (P<0.05), while ALB, total cholesterol, serum Na, fibrinogen, lymphocyte were significantly decreased (P<0.05). CONUT (OR=1.499, 95% CI 1.092⁃2.057, P=0.012), CTP score (OR=1.474, 95% CI 1.178⁃1.844, P=0.001) were independent risk factors for 90⁃day mortality in liver cirrhosis patients complicated with HE. AUC of CTP, CONUT and CONUT⁃CTP scoring models were 0.90, 0.94 and 0.95, respectively. Kaplan⁃Meier analysis showed that the survival rate in CONUT⁃CTP≥7.50 group was significantly lower than that in <7.50 group (P<0.000 1). Conclusions: CONUT⁃CTP score has good predictive value for the prognosis of liver cirrhosis patients complicated with HE, CONUT⁃CTP ≥7.50 indicates poor prognosis.