Prognostic Factors in 337 Inpa tien ts w ith L iver C irrhosis

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1 Journal of Cap ital M edical University Jun Vol. 31 No. 3 [ do i: / j. issn ] (1. ; 2. ), 337,,, 5 COX %, %, %, %, %, %, 5 ; ; ; R Prognostic Factors in 337 Inpa tien ts w ith L iver C irrhosis SUN L i2dong 1, ZHANG Mei 13, TANG Zhe 2 (1. D epartm ent of Gastroenterology, X uanw u Hospital, CapitalM edical U niversity; 2. D epartm ent of Epidem iology and Society M edicine, X uanw u Hospital, Capital M edical U niversity) ABSTRACT O bjective To study the risk factors for poor p rognosis in patients with liver cirrhosis. M ethods A total of 337 cirrhosis patients were included in the study. The hosp ital records were analyzed retrospectively, and all patients were followed up by phone call ormail. The associated clinical and laboratory variables were studied by univariate and multivariate statistical analysis. Results The survival rates at 32months, 62months, 12year, 32years and 52years after hosp italization were 89. 0%, 87. 8%, 82. 2%, 77. 4% 59. 1% and 46. 9%. Univariate analysis shows that the factors associated with mortality during hosp italization were serum total bilirubin, direct bilirubin, album in, creatinine, blood urea nitrogen, hemoglobin, p rothrombin time, INR for p rothrombin time and encephalopathy, hepatorenal syndrome, ascites, and upper gastrointestinal hemorrhage. Univariate analysis showed that the factors associated with mortality 52years after enrollment were serum total bilirubin, direct bilirubin, album in, creatinine, blood urea nitrogen, hemoglobin, p rothrombin time, INR for p rothrombin time, cholesterol, low density lipop rotein, serum sodium and encephalopathy, hepatorenal syndrome, ascites and age. Multivariate analysis showed that serum album in, creatinine, blood urea nitrogen, total bilirubin, p rothrombin time, low density lipop rotein, ascites and age were independently related to 52year mortality. ConclusionFor cirrhotic patients, a number of clinical factors were significantly correlated with mortality in hosp ital or 5 years after enrollment. function is the main factor for p rognosis. KEY WO RD S liver cirrhosis; p rognosis; mortality; p rognostic factors A scites and age were also significantly related to 52year mortality. The liver 2,,,,,, 3 Corresponding author, E2mail: zhang2955@ sina. com, ,,

2 394 31,, , 150 (44. 5% ), 22 (6. 5% ), 66 (19. 6% ), 83 ( 24. 6% ), 16 ( 4. 7% ) 74. 2% d () [ 1 ] ) : ,, (Hb) (WBC ) ( PLT) 46. 9% , (ALT AST) (ALB ) ( TB IL DB IL) (CR) ( K Na) ( GLU ) ( TG) ( HDL ) (LDL ), ( PT) ( INR), B CT ( PV ), B CT 2): ,, ,, , 295 5, , SPSS t 2 5,P < 0. 05, Kap lan2meier COX, = ) :152 (45. 1% ), 5 : 41 (12. 2% ) 40 ( 11. 9% ), 33 (9. 8% ) 24 ( 8. 1% ) 23 (7. 3% ) 2) , 89. 0%, %, %, %, %, ) 37, 89. 0%, (300 ) (37 ) 2,,, 1 2 2) , 135, 160, % 295 (135 ) (160 ), 5

3 3 : Age /year Tab. Item A lanine am inotransferase / (U L - 1 ) A spartate am inotransferase / (U L - 1 ) Total bilirubin / ( mol L - 1 ) D irect bilirubin / ( mol L - 1 ) A lbum in / ( g L - 1 ) Globulin / ( g L - 1 ) Creatinine / ( mol L - 1 ) U rea nitrogen / (mmol L - 1 ) Triglyceride / (mmol L - 1 ) Cholesterol/ (mmol L - 1 ) Low2density lipop rotein / (mmol L - 1 ) H igh2density lipop rotein / (mmol L - 1 ) Glucose / (mmol L - 1 ) Potassium / (mmol L - 1 ) Sodium / (mmol L - 1 ) Prothrombin time / s INR for p rothrombin time Hemoglobin / ( g L - 1 ) W hite blood cell/ (10 9 L - 1 ) Platelet/ (10 9 L - 1 ) D iameter of Portal vein /cm Gender Etiology A scites 1 1 Com p a riso n o f m a in c lin ica l cha rac te ristic s be tw e en two g ro up s ( a fte r ho sp ita liza tio n) ( gx s) Survival( n = 300) Death ( n = 37) Ta b. 2 Com p a riso n o f o the r cha ra c te ristic s be tw ee n the su rvived and d ied p a tien ts g ro up s du ring ho sp ita liza tio n n ( % ) Item s Survival( n = 300) Death ( n = 37) Male 182 (85. 6) 27 (12. 9) Female 118 (90. 6) 10 (7. 8) V irus 170 (88. 5) 22 (11. 5) O thers 130 (89. 7) 15 (10. 3) Positive 176 (58. 6) 31 (83. 8) Negative 124 (41. 4) 6 (16. 2) 2 P = = 0. 10, > 605, 5, 3 4 3) 5 COX COX,, t 85, 5 3,,, 10,, 5 40% [ 2 ], P

4 Tab. 3 Com p a riso n o f m a in c lin ica l cha rac te ristic s be tw e en two g ro up s ( a t 5 ye a rs) ( gx s) Item Age /year A lanine am inotransferase / (U L - 1 ) A spartate am inotransferase / (U L - 1 ) Total bilirubin / ( mmol L - 1 ) D irect bilirubin / ( mmol L - 1 ) A lbum in / ( g L - 1 ) Globulin / ( g L - 1 ) Creatinine / ( mol L - 1 ) U rea nitrogen / (mmol L - 1 ) Triglyceride / (mmol L - 1 ) Cholesterol/ (mmol L - 1 ) Low2density lipop rotein / (mmol L - 1 ) H igh2density lipop rotein / (mmol L - 1 ) Glucose / (mmol L - 1 ) Potassium / (mmol L - 1 ) Sodium / (mmol L - 1 ) Prothrombin time / s INR for p rothrombin time Hemoglobin / ( g L - 1 ) W hite blood cell/ (10 9 L - 1 ) Platelet/ (10 9 L - 1 ) D iameter of portal vein /cm Survival( n = 135) Death ( n = 160) t P Gender Etiology 4 5 Ta b. 4 Com p a riso n o f o the r c lin ica l cha ra c te ristic s be tw ee n two g ro up s ( a t 5 ye a rs) n ( % ) Item s Survival( n = 135) Death ( n = 160) Male 73 (54. 1) 103 (64. 4) Female 62 (45. 9) 57 (35. 6) V irus 72 (53. 3) 97 (60. 5) O thers 63 (46. 7) 63 (39. 5) 2 P UGIB 53 (39. 3) 80 (50. 0) HE 24 (17. 8) 52 (32. 5) HRS 5 (3. 7) 25 (15. 6) A scites 65 (44. 3) 104 (65. 0) U G IB: Upper gastrointestinal2bleeding; HE: Hepatic encephalopathy; HRS: Hepatorenal syndrome. 5 5 Tab. 5 R e su lts o f CO X m u ltiva ria te ana lysis o n 5 2yea r o u tcom e in c irrho tic p a tien ts Item B W aldx2 P Exp (B ) Total bilirubin A lbum in Creatinine B lood urea nitrogen Low2density lipoprotein Prothrombin time A scites Age ),,,, Serra M A [ 3 ], 2)5

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