Value of interleukin-6 combined with Model for End-Stage Liver Disease score in predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure

Yan WANG; Ying XU; Wei SUN; Li CHEN; Jianhe GAN; Jing GU

doi:10.3969/j.issn.1001-5256.2022.08.011

Volume 38 Issue 8

Aug. 2022

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Value of interleukin-6 combined with Model for End-Stage Liver Disease score in predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2022.08.011

Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China

Research funding:

the National S & T Major Project (2017ZX10203201002-002);

Suzhou Youth Science and Technology Fund (KJXW2020003)

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Corresponding author: GU Jing, 296326823@qq.com(ORCID: 0000-0002-7904-2793)
Received Date: 2021-10-21
Accepted Date: 2021-12-06
Published Date: 2022-08-20

Abstract

Abstract

Objective To investigate the value of interleukin-6 (IL-6) combined with Model for End-stage Liver Disease (MELD) score in predicting the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 86 patients with HBV-ACLF who were hospitalized in The First Affiliated Hospital of Soochow University from January 2015 to December 2018 were enrolled, and according to their survival status after follow-up for 90 days, they were divided into death group with 50 patients and survival group with 36 patients. ELISA was used to measure the serum level of IL-6, and a statistical analysis was performed for general information. 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 two groups; the chi-square test was used for comparison of categorical data between two groups. A Pearson correlation analysis was performed for IL-6 and other variables; a binary logistic regression analysis was used to investigate the independent risk factors for the prognosis of patients with HBV-ACLF; the receiver operating characteristic (ROC) curve was used to assess the value of IL-6 combined with MELD score in predicting the prognosis of HBV-ACLF. Results There were significant differences between the death group and the survival group in hematocrit (t=2.413), platelet count (t=6.584), total bilirubin (TBil) (t=-8.070), prothrombin time (PT) (U=77.500), international standardized ratio (U=102.000), HBV DNA (t=-2.767), IL-6 (t=-16.543), and MELD score (t=-8.192), and the death group had a significantly higher level of IL-6 than the survival group (27.13±12.18 pg/mL vs 9.72±5.56 pg/mL, P < 0.001). The Pearson correlation analysis showed that IL-6 was positively correlated with TBil and PT (r=0.579 and 0.681, both P < 0.001). The binary logistic regression analysis showed that IL-6 (odds ratio[OR]=1.480, 95% confidence interval [CI]: 1.196~1.833, P=0.007) and MELD score (OR=1.128, 95%CI: 1.033~1.231, P < 0.001) were independent risk factors for the death of HBV-ACLF patients within 90 days. IL-6 combined with MELD score had an area under the ROC curve (AUC) of 0.891 (95%CI: 0.778~0.999), with a higher AUC than IL-6 (AUC=0.838, 95%CI: 0.687~0.989) or MELD score (AUC=0.783, 95%CI: 0.634~0.933). IL-6 combined with MELD score had a significantly higher value than IL-6 alone in predicting the prognosis of patients with HBV-ACLF (Z=-2.257, P=0.024). Conclusion IL-6 combined with MELD score can be used as a good model for predicting the short-term prognosis of patients with HBV-ACLF.
- Hepatitis B Virus,
- Acute-On-Chronic Liver Failure,
- Prognosis

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References(29)

References

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Value of interleukin-6 combined with Model for End-Stage Liver Disease score in predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2022.08.011