中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 3
Mar.  2024
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(3): 516-520

Influencing factors for death within 30 days in patients with decompensated hepatitis B cirrhosis and hepatic encephalopathy

DOI: 10.12449/JCH240313
  • 1.

    Department of Traditional Chinese Medicine，Nanyang Central Hospital，Nanyang，Henan 473000，China

  • 2.

    Center of Integrated Traditional Chinese and Western Medicine，Beijing Ditan Hospital，Beijing 100015，China

Research funding:

State Administration of Traditional Chinese Medicine High-Level Key Discipline Construction Project (zyyzdxk-2023005)

More Information
  • Corresponding author: WANG Xianbo， wangxianbo638@163.com （ORCID： 0000-0002-3593-5741）
  • Received Date: 2023-06-02
  • Accepted Date: 2023-07-31
  • Published Date: 2024-03-20
    Abstract
  •   Objective  To investigate the influencing factors for death within 30 days in patients with decompensated hepatitis B cirrhosis and hepatic encephalopathy.  Methods  A retrospective analysis was performed for 616 patients with hepatitis B cirrhosis and hepatic encephalopathy in Beijing Ditan Hospital from January 2008 to April 2018， and all patients were followed up for 30 days. According to their prognosis， they were divided into survival group with 488 patients and death group with 128 patients. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Cox regression analysis was used to investigate the independent risk factors for death within 30 days in patients with hepatitis B cirrhosis and hepatic encephalopathy.  Results  The multivariate Cox regression analysis showed that age （hazard ratio ［HR］=1.029， 95% confidence interval ［CI］： 1.014‍ — ‍1.044， P<0.001）， Model for End-Stage Liver Disease （MELD） score （HR=1.118， 95%CI： 1.098‍ — ‍1.139， P<0.001）， and neutrophil-to-lymphocyte ratio （NLR） （HR=1.036， 95%CI： 1.015‍ — ‍1.057， P=0.001） were independent risk factors for death within 30 days in patients with hepatitis B cirrhosis and hepatic encephalopathy. The stratified analysis showed that the patients with a MELD score of≥20 and an NLR of≥4 had a higher risk of death， with a 30-day mortality rate of 57.1% （80/140）. The patients with a MELD score of<20 and an NLR of<4 had a 30-day mortality rate of 3.9% （9/232）.  Conclusion  Age， MELD score， and NLR are independent risk factors for death within 30 days in patients with hepatitis B cirrhosis and hepatic encephalopathy， and patients with a MELD score of≥20 and an NLR of≥4 tend to have a high risk of death.

     

    • FullText(HTML)
  • loading
    • References(13)
  • [1]
    VILSTRUP H, AMODIO P, BAJAJ J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver[J]. Hepatology, 2014, 60( 2): 715- 735. DOI: 10.1002/hep.27210.
    [2]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of hepatic encephalopathy in cirrhosis[J]. J Clin Hepatol, 2018, 34( 10): 2076- 2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007.

    中华医学会肝病学分会. 肝硬化肝性脑病诊疗指南[J]. 临床肝胆病杂志, 2018, 34( 10): 2076- 2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007.
    [3]
    BUSTAMANTE J, RIMOLA A, VENTURA PJ, et al. Prognostic significance of hepatic encephalopathy in patients with cirrhosis[J]. J Hepatol, 1999, 30( 5): 890- 895. DOI: 10.1016/s0168-8278(99)80144-5.
    [4]
    JEPSEN P, OTT P, ANDERSEN PK, et al. Clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study[J]. Hepatology, 2010, 51( 5): 1675- 1682. DOI: 10.1002/hep.23500.
    [5]
    MUMTAZ K, ISSAK A, PORTER K, et al. Validation of risk score in predicting early readmissions in decompensated cirrhotic patients: a model based on the administrative database[J]. Hepatology, 2019, 70( 2): 630- 639. DOI: 10.1002/hep.30274.
    [6]
    BAJAJ JS, HAFEEZULLAH M, HOFFMANN RG, et al. Navigation skill impairment: Another dimension of the driving difficulties in minimal hepatic encephalopathy[J]. Hepatology, 2008, 47( 2): 596- 604. DOI: 10.1002/hep.22032. PMID: 18000989.
    [7]
    SUK KT, BAIK SK, YOON JH, et al. Revision and update on clinical practice guideline for liver cirrhosis[J]. Korean J Hepatol, 2012, 18( 1): 1- 21. DOI: 10.3350/kjhep.2012.18.1.1.
    [8]
    XU XY, DING HG, LI WG, et al. Chinese guidelines on management of hepatic encephalopathy in cirrhosis[J]. World J Gastroenterol, 2019, 25( 36): 5403- 5422. DOI: 10.3748/wjg.v25.i36.5403.
    [9]
    UMAPATHY S, DHIMAN RK, GROVER S, et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy[J]. Am J Gastroenterol, 2014, 109( 7): 1011- 1019. DOI: 10.1038/ajg.2014.107.
    [10]
    HU XP, GAO J. International normalized ratio and Model for End-stage Liver Disease score predict short-term outcome in cirrhotic patients after the resolution of hepatic encephalopathy[J]. World J Gastroenterol, 2019, 25( 26): 3426- 3437. DOI: 10.3748/wjg.v25.i26.3426.
    [11]
    TANDON P, KUMAR D, SEO YS, et al. The 22/11 risk prediction model: a validated model for predicting 30-day mortality in patients with cirrhosis and spontaneous bacterial peritonitis[J]. Am J Gastroenterol, 2013, 108( 9): 1473- 1479. DOI: 10.1038/ajg.2013.204.
    [12]
    ZAHOREC R. Neutrophil-to-lymphocyte ratio. Sixteen-year-long history since publication of our article in Bratislava Medical Journal[J]. Bratisl Lek Listy, 2017, 118( 6): 321- 323. DOI: 10.4149/BLL_2017_062.
    [13]
    SHI K, HUANG Y, ZHANG Q, et al. Neutrophil-lymphocyte ratio and the risk of 30-day mortality in patients with overt hepatic encephalopathy[J]. Eur J Gastroenterol Hepatol, 2022, 34( 5): 529- 536. DOI: 10.1097/MEG.0000000000002368.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (316) PDF downloads(48) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return