Establishment and evaluation of a multivariate Cox proportional-hazards prediction model for mortality during short-term hospitalization in patients with liver cirrhosis and sepsis

Linlin XUE; Binghan LI; Chunyun LIU; Weikun LI; Lixian CHANG; Li LIU

doi:10.3969/j.issn.1001-5256.2023.05.014

Volume 39 Issue 5

May 2023

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2023 > 39(5): 1089-1097

PDF( 2199 KB)

Establishment and evaluation of a multivariate Cox proportional-hazards prediction model for mortality during short-term hospitalization in patients with liver cirrhosis and sepsis

DOI: 10.3969/j.issn.1001-5256.2023.05.014

1.
School of Public Health, Dali University, Dali, Yunnan 671000, China
2.
Yunnan Clinical Medical Center for Infectious Diseases, The Third People's Hospital of Kunming, Kunming 650041, China

Research funding:

Special Fund for Scientific Research of You'an Professional Alliance (LM202014)

More Information

Corresponding author: LIU Li, liuli197210@163.com (ORCID: 0000-0001-7712-4931)
Received Date: 2022-12-01
Accepted Date: 2023-02-21
Published Date: 2023-05-20

Abstract

Abstract

Objective To establish a Cox proportional-hazards prediction model for mortality during short-term hospitalization in patients with liver cirrhosis and sepsis. Methods A retrospective analysis was performed for the clinical data of 336 patients with liver cirrhosis and sepsis who were admitted to The Third People's Hospital of Kunming from January 2012 to August 2022, and according to whether the patient died during short-term hospitalization, they were divided into death group with 40 patients and survival group with 296 patients. Demographic data, comorbidities, and clinical biochemical parameters were collected and compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two 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. The multivariate Cox analysis was used for screening of variables, then a Cox proportional-hazards prediction model was established, and hazard ratio (HR) and its 95% confidence interval [CI] were calculated; C-index index was used to evaluate the prediction accuracy of the model. The Cox proportional-hazards prediction model was visualized by a nomogram, and calibration curve was plotted to evaluate the consistency between the prediction results of the model and the actual condition. Results Among the 336 patients, there were 261 male patients (77.7%) and 75 female patients (22.3%), with a mean age of 50.0±10.6 years, and 40 patients died, with a mean hospital stay of 16.8±11.3 days (range 8.2-23.0 days). Compared with the survival group, the death group had a significantly higher proportion of patients with an age of ≥60 years, a history of invasive operation within the past two weeks, gastrointestinal bleeding, hepatic encephalopathy (HE) or hepatorenal syndrome (HRS), a significantly higher Modified Early Warning Score (MEWS) score, and significantly higher levels of prothrombin time (PT), activated partial thromboplastin time, international normalized ratio, D-dimer, CD4/CD8 ratio, lactate, white blood cell count, norepinephrine, total bilirubin, interleukin-6, procalcitonin, high-sensitivity C-reactive protein (hsCRP), blood urea nitrogen, and creatinine (all P < 0.05), as well as significantly lower levels of red blood cell count, hemoglobin, albumin, total cholesterol, low-density lipoprotein, and high-density lipoprotein (all P < 0.05). The multivariate Cox regression analysis showed that age (HR=2.602, 95%CI: 1.277-5.303, P=0.008), HE (HR=2.516, 95%CI: 1.258-5.033, P=0.009), HRS (HR=2.324, 95%CI: 1.010-5.349, P=0.047), hsCRP (HR=1.008, 95%CI: 1.003-1.013, P=0.004), MEWS score (HR=1.205, 95%CI: 1.022-1.422, P=0.027), and PT (HR=1.076, 95%CI: 1.030-1.124, P=0.027) were independent influencing factors for death in patients with liver cirrhosis and sepsis. The model showed a C-index of 0.857 (95%CI: 0.815-0.920), suggesting that the model had relatively high prediction accuracy, and the calibration curve showed good consistency between the predicted risk and the actual risk. Conclusion The Cox proportional-hazards prediction model established for death during short-term hospitalization in patients with liver cirrhosis and sepsis can be used to predict the risk of death during short-term hospitalization in patients with liver cirrhosis and sepsis, thereby guiding clinical medical staff to take targeted intervention measures to avoid or reduce the possibility of death in patients.
- Liver Cirrhosis,
- Sepsis,
- Risk Factors,
- Proportional Hazards Models

FullText(HTML)

References(32)

References

[1]	DELLINGER RP, LEVY MM, SCHORR CA, et al. 50 years of sepsis investigation/enlightenment among adults-the long and winding road[J]. Crit Care Med, 2021, 49(10): 1606-1625. DOI: 10.1097/CCM.0000000000005203.
[2]	HUANG HK, CHEN HY, HSU YC. Comparing the prognosis of patient with alcohol and nonalcohol-associated cirrhosis with bacteremia[J]. Alcohol Alcohol, 2020, 55(5): 512-517. DOI: 10.1093/alcalc/agaa057.
[3]	CHEN HY, HSU YC. Afebrile bacteremia in adult emergency department patients with liver cirrhosis: clinical characteristics and outcomes[J]. Sci Rep, 2020, 10(1): 7617. DOI: 10.1038/s41598-020-64644-7.
[4]	CHATTERJEE S, KAWAHARA R, TJONDRO HC, et al. Serum N-glycomics stratifies bacteremic patients infected with different pathogens[J]. J Clin Med, 2021, 10(3): 516. DOI: 10.3390/jcm10030516.
[5]	JOHNSON AL, RATNASEKERA IU, IRVINE KM, et al. Bacteraemia, sepsis and antibiotic resistance in Australian patients with cirrhosis: a population-based study[J]. BMJ Open Gastroenterol, 2021, 8(1): e000695. DOI: 10.1136/bmjgast-2021-000695.
[6]	Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of hepatitis C(2019 version)[J]. J Clin Hepatol, 2019, 35(12): 2670-2686. DOI: 10.3969/j.issn.1001-5256.2019.12.008. 中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2670-2686. DOI: 10.3969/j.issn.1001-5256.2019.12.008.
[7]	Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J]. J Clin Hepatol, 2011, 27(1): 113-128. http://lcgdbzz.org/article/id/LCGD201101035 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 临床肝胆病杂志, 2011, 27(1): 113-128. http://lcgdbzz.org/article/id/LCGD201101035
[8]	Fatty Liver Expert Committee, Chinese Medical Doctor Association, National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association. Guidelines of prevention and treatment for alcoholic liver disease: a 2018 update[J]. J Clin Hepatol, 2018, 34(5): 939-946. DOI: 10.3969/j.issn.1001-5256.2018.05.006. 中国医师协会脂肪性肝病专家委员会, 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 酒精性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 939-946. DOI: 10.3969/j.issn.1001-5256.2018.05.006.
[9]	National Workshop on Fatty Liver and AlcoholicLiver Disease, Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management ofprimary biliary cholangitis (2021)[J]. J Clin Hepatol, 2022, 38(1): 35-41. DOI: 10.3969/j.issn.1001-5256.2022.01.007 中华医学会肝病学分会. 原发性胆汁性胆管炎的诊断和治疗指南(2021)[J]﹒临床肝胆病杂志, 2022, 38(1): 35-41. DOI: 10.3969/j.issn.1001-5256.2022.01.007
[10]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and management of autoimmune hepatitis(2015)[J]. J Clin Hepatol, 2016, 32(1): 9-22. DOI: 10.3969/j.issn.1001-5256.2016.01.002. 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 自身免疫性肝炎诊断和治疗共识(2015)[J]. 临床肝胆病杂志, 2016, 32(1): 9-22. DOI: 10.3969/j.issn.1001-5256.2016.01.002.
[11]	SINGER M, DEUTSCHMAN CS, SEYMOUR CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 801-810. DOI: 10.1001/jama.2016.0287.
[12]	ZHENG RQ, ZHANG YF, RONG ZQ, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021, interpretation and expectation[J]. Chin Critical Care Med, 2021, 33(10): 1159- 1164. DOI: 10.3760/cma.j.cn121430-20211009-01442. 郑瑞强, 张艺芬, 荣子琪, 等. 《拯救脓毒症运动: 脓毒症与感染性休克治疗国际指南2021版》解读与展望[J]. 中华危重病急救医学, 2021, 33(10): 1159-1164. DOI: 10.3760/cma.j.cn121430-20211009-01442.
[13]	FLEISCHMANN-STRUZEK C, MIKOLAJETZ A, SCHWARZKOPF D, et al. Challenges in assessing the burden of sepsis and understanding the inequalities of sepsis outcomes between National Health Systems: secular trends in sepsis and infection incidence and mortality in Germany[J]. Intensive Care Med, 2018, 44(11): 1826-1835. DOI: 10.1007/s00134-018-5377-4.
[14]	HASSAN EA, ABDEL REHIM AS, AHMED AO, et al. Clinical value of presepsin in comparison to hsCRP as a monitoring and early prognostic marker for sepsis in critically ill patients[J]. Medicina (Kaunas), 2019, 55(2): 36. DOI: 10.3390/medicina55020036.
[15]	MILBRANDT EB, ELDADAH B, NAYFIELD S, et al. Toward an integrated research agenda for critical illness in aging[J]. Am J Respir Crit Care Med, 2010, 182(8): 995-1003. DOI: 10.1164/rccm.200904-0630CP.
[16]	SCHMITT F, MANOLOV V, MORGENSTERN J, et al. Acute fibrinolysis shutdown occurs early in septic shock and is associated with increased morbidity and mortality: results of an observational pilot study[J]. Ann Intensive Care, 2019, 9(1): 19. DOI: 10.1186/s13613-019-0499-6.
[17]	VAN VUGHT LA, UHEL F, DING C, et al. Consumptive coagulopathy is associated with a disturbed host response in patients with sepsis[J]. J Thromb Haemost, 2021, 19(4): 1049-1063. DOI: 10.1111/jth.15246.
[18]	BATES SM. D-dimer assays in diagnosis and management of thrombotic and bleeding disorders[J]. Semin Thromb Hemost, 2012, 38(7): 673-682. DOI: 10.1055/s-0032-1326782.
[19]	INNOCENTI F, GORI AM, GIUSTI B, et al. Prognostic value of sepsis-induced coagulation abnormalities: an early assessment in the emergency department[J]. Intern Emerg Med, 2019, 14(3): 459-466. DOI: 10.1007/s11739-018-1990-z.
[20]	BAKKER J. Lost in translation: on lactate, hypotension, sepsis- induced tissue hypoperfusion, quantitative resuscitation and surviving sepsis campaign bundles[J]. Crit Care Med, 2015, 43(3): 705-706. DOI: 10.1097/CCM.0000000000000870.
[21]	BOHRA A, WORLAND T, HUI S, et al. Prognostic significance of hepatic encephalopathy in patients with cirrhosis treated with current standards of care[J]. World J Gastroenterol, 2020, 26(18): 2221-2231. DOI: 10.3748/wjg.v26.i18.2221.
[22]	KROUPINA K, BÉMEUR C, ROSE CF. Amino acids, ammonia, and hepatic encephalopathy[J]. Anal Biochem, 2022, 649: 114696. DOI: 10.1016/j.ab.2022.114696.
[23]	TRANAH TH, BALLESTER MP, CARBONELL-ASINS JA, et al. Plasma ammonia levels predict hospitalisation with liver-related complications and mortality in clinically stable outpatients with cirrhosis[J]. J Hepatol, 2022, 77(6): 1554-1563. DOI: 10.1016/j.jhep.2022.07.014.
[24]	ARORA V, MAIWALL R, RAJAN V, et al. Terlipressin is superior to noradrenaline in the management of acute kidney injury in acute on chronic liver failure[J]. Hepatology, 2020, 71(2): 600-610. DOI: 10.1002/hep.30208.
[25]	FEBRES ALDANA C, POPPITI RJ. Cholangitis lenta causing bile cast nephropathy: A unique model of hepatorenal failure in sepsis[J]. Fetal Pediatr Pathol, 2018, 37(6): 424-432. DOI: 10.1080/15513815.2018.1520945.
[26]	GINÈS P, FERNÁNDEZ J, DURAND F, et al. Management of critically-ill cirrhotic patients[J]. J Hepatol, 2012, 56 (Suppl 1): S13-24. DOI: 10.1093/ckj/sfac025.
[27]	BARLOW B, PONNALURI S, BARLOW A, et al. Targeting the gut microbiome in the management of sepsis-associated encephalopathy[J]. Front Neurol, 2022, 13: 999035. DOI: 10.3389/fneur.2022.999035.
[28]	ALI WA, BAZAN NS, ELBERRY AA, et al. A randomized trial to compare procalcitonin and C-reactive protein in assessing severity of sepsis and in guiding antibacterial therapy in Egyptian critically ill patients[J]. Ir J Med Sci, 2021, 190(4): 1487-1495. DOI: 10.1007/s11845-020-02494-y.
[29]	GREALISH M, CHIEW AL, VARNDELL W, Depczynski B. The relationship between admission glucose and lactate with critical illness amongst adult patients presenting to the emergency department[J]. Acta Diabetol, 2021, 58(10): 1343-1349. DOI: 10.1007/s00592-021-01725-7.
[30]	GÖK R, GÖK A, BULUT M. Assessing prognosis with modified early warning score, rapid emergency medicine score and worthing physiological scoring system in patients admitted to intensive care unit from emergency department[J]. Int Emerg Nurs, 2019, 43: 9-14. DOI: 10.1016/j.ienj.2018.06.002.
[31]	TANG R, SHI LP, WEI YY, et al. Correlation analysis of MEWS, length of stay in lCU and death of patients who were unplanned transferred to lCU before transfer[J]. Nursing Prac Res, 2022, 19(2): 179-183. DOI: 10.3969/j.issn.1672-9676.2022.02.005. 唐蓉, 石兰萍, 魏莹莹, 等. 非计划性转入ICU患者转入前MEWS与ICU住院时长及死亡情况的相关性分析[J]. 护理实践与研究, 2022, 19(2): 179-183. DOI: 10.3969/j.issn.1672-9676.2022.02.005.
[32]	KHAN A, SARMA D, GOWDA C, et al. The Role of Modified Early Warning Score (MEWS) in the prognosis of acute pancreatitis[J]. Oman Med J, 2021, 36(3): e272. DOI: 10.5001/omj.2021.72.

Relative Articles

[1]	Jiaxin LIANG, Baolin XU, Yu CHENG, Yong WEI. Role of ferroptosis in hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2024, 40(8): 1693-1698. doi: 10.12449/JCH240830
[2]	Jinrui ZHANG, Hao WU, Yi BAI, Yamin ZHANG. Effect of trimetazidine on a rat model of bile duct ischemia-reperfusion injury and its mechanism[J]. Journal of Clinical Hepatology, 2022, 38(11): 2546-2550. doi: 10.3969/j.issn.1001-5256.2022.11.021
[3]	Zhen LI, Ke WANG, Kaiqiang WANG, Kexian YU. Research advances in targeting autophagy to alleviate hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2022, 38(1): 210-214. doi: 10.3969/j.issn.1001-5256.2022.01.037
[4]	Zhen LI, Yihao ZENG, Ke WANG, Kaiqiang WANG, Kexian YU. Research advances in the prevention and treatment of hepatic ischemia-reperfusion injury with traditional Chinese medicine components[J]. Journal of Clinical Hepatology, 2022, 38(2): 471-476. doi: 10.3969/j.issn.1001-5256.2022.02.044
[5]	Yangyang WANG, Xueying PENG, Jie MENG, Boran AN, Wenjuan HE, Sucai LU, Yan CHEN, Liwen KONG, Chuan NIU, Cong LIU, Wei HUANG, Yingjian HOU. Protective effect of resolvin D1 pretreatment in a rat model of hepatic ischemia-reperfusion injury and its mechanism[J]. Journal of Clinical Hepatology, 2021, 37(6): 1373-1378. doi: 10.3969/j.issn.1001-5256.2021.06.030
[6]	Mi Kai, Huang Rui. Protective effect of urolithin A pretreatment in a rat model of hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2020, 36(8): 1783-1787. doi: 10.3969/j.issn.1001-5256.2020.08.021
[7]	Zhang ShiLong, Peng CiJun, Feng ZanJie, Gao WeiDong, Duan YuLing, Fan GuoXin. Mechanism of action of microRNA in the regulation of hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2019, 35(7): 1629-1631. doi: 10.3969/j.issn.1001-5256.2019.07.045
[8]	Li Yang, Shu DeJun, Peng CiJun, Feng ZanJie, Mei Yong, Xiong Kun. Effect of erythropoietin on the mRNA expression of apoptosis genes bcl-2 and bax in rats with fatty liver disease after hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2019, 35(1): 157-160. doi: 10.3969/j.issn.1001-5256.2019.01.030
[9]	Wang JingYuan, Li ShengWei, Gong JianPing, Jiang DeQuan. Role of silent information regulator 1 in hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2019, 35(6): 1388-1391. doi: 10.3969/j.issn.1001-5256.2019.06.047
[10]	Luo YanQing, Feng ChunLin, Mei Yong, Du Chao, Ceng PengFei, Wang Jun, Wang GuoXing, Zhao Liang, Leng Kai. Protective effect of hepatocyte growth-promoting factor against liver ischemia-reperfusion injury in rats and its mechanism of action[J]. Journal of Clinical Hepatology, 2019, 35(2): 364-367. doi: 10.3969/j.issn.1001-5256.2019.02.024
[11]	Gao WeiDong, Feng ZanJie, Peng CiJun, Li Yang, Wu Bo, Geng Xin. Association between high-mobility group box B1 and hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2019, 35(3): 669-671. doi: 10.3969/j.issn.1001-5256.2019.03.049
[12]	Yang LongCan, Zhang XuYang, Pan NingBo, Yu Xi, Li JiWei, Zhang Ying. Effect of rapamycin on the expression of autophagy-related proteins Unc-51 like autophagy activating kinase 1 and microtubule-associated protein 1 light chain 3 in hepatic ischemia-reperfusion injury and its significance[J]. Journal of Clinical Hepatology, 2019, 35(10): 2261-2265. doi: 10.3969/j.issn.1001-5256.2019.10.026
[13]	Chen BaoHe, Li WenMei. Effect of ulinastatin combined with ischemic preconditioning on hepatic ischemia-reperfusion injury in rats[J]. Journal of Clinical Hepatology, 2018, 34(2): 368-372. doi: 10.3969/j.issn.1001-5256.2018.02.030
[14]	Ren ZhiZhong, Zhang YueWei. Advances in the application of GPC3 in treatment of liver cancer[J]. Journal of Clinical Hepatology, 2017, 33(7): 1369-1372. doi: 10.3969/j.issn.1001-5256.2017.07.037
[15]	Xu Feng, Liu XiaoLin, Wang Chao, Dai ChaoLiu. Protective effect of prostaglandin E1 pretreatment against liver ischemia-reperfusion injury in rats with cholestasis[J]. Journal of Clinical Hepatology, 2017, 33(5): 899-904. doi: 10.3969/j.issn.1001-5256.2017.05.022
[16]	Wang QingQing, Zhao Xin, Chen YuChao, Dou Jian. Research advances in mechanisms and intervention of hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2016, 32(6): 1225-1229. doi: 10.3969/j.issn.1001-5256.2016.06.049
[17]	Chen XuXiao, Chen YongJun. PI3K / Akt / mTOR signaling pathway and malignant hepatobiliary tumors[J]. Journal of Clinical Hepatology, 2015, 31(6): 989-991. doi: 10.3969/j.issn.1001-5256.2015.06.040
[18]	Wu ZhangHui, Shen Min, Li Long, Wei Jia. Association between PI3K/Akt/mTOR/p70S6K signaling pathway and hepatic fibrosis[J]. Journal of Clinical Hepatology, 2015, 31(11): 1928-1932. doi: 10.3969/j.issn.1001-5256.2015.11.043
[19]	Wu Gang, Zheng Jie, Hu GuoXin, Peng YanZhong. Role of liver nonparenchymal cells in hepatic ischemia-reperfusion injury[J]. Journal of Clinical Hepatology, 2014, 30(12): 1366-1369. doi: 10.3969/j.issn.1001-5256.2014.12.033
[20]	Gao Jun, Chen Gong, Lu: Long. Protective role and immunoregulatory effect of CXCR3 in hepatic ischemia- reperfusion injury[J]. Journal of Clinical Hepatology, 2014, 30(8): 790-794. doi: 10.3969/j.issn.1001-5256.2014.08.023

Supplements(0)

Cited By

Cited by

Periodical cited type(30)

1.	汪淑佳，俞黎. 多学科团队诊疗模式下的PDCA循环管理在梗阻性黄疸患者围术期护理中的应用效果分析. 中国社区医师. 2025(02): 96-98 .
2.	易衡，何芬，王曦，冯谦，唐杰，卿小琼，孙菲菲，陈重. 超声引导下PTCD治疗晚期MOJ疗效及预后因素分析. 武汉大学学报(医学版). 2024(07): 814-819 .
3.	李鸿. 老年晚期恶性梗阻性黄疸患者实时超声弹性成像定量分析对PTCD预后的预测价值. 昆明医科大学学报. 2023(01): 122-127 .
4.	李鸿. 老年晚期恶性梗阻性黄疸患者实时超声弹性成像定量分析对PTCD预后的评估价值. 昆明医科大学学报. 2023(02): 150-155 .
5.	梁亚丽，李馨，夏俊杰. 胰腺癌梗阻性黄疸患者经皮穿刺胆管引流术后发生胰腺炎的危险因素分析. 实用癌症杂志. 2023(08): 1321-1324 .
6.	杨立新，刘茜，周晶晶，唐亚丹，傅鹏，戴峰，白淑芬. 不同方法PTCD应用于梗阻性黄疸治疗中的体会. 现代医用影像学. 2023(12): 2229-2231+2235 .
7.	华建军. 超声引导下经皮肝穿刺胆管引流术治疗对阻塞性黄疸病人胆红素水平与肝功能的影响研究. 贵州医药. 2022(02): 226-227 .
8.	黄道琼，沈小叶，刘骏，刘月娥，陈瑜. 回授法在经皮肝穿刺胆管引流术后的应用. 介入放射学杂志. 2022(03): 294-297 .
9.	彭赵宏，张德志，施万印，赵本胜，熊壮，汪名权，宋文，陶龙香，刘斌，张帅，程翔. ~(125)I粒子支架治疗恶性梗阻性黄疸支架通畅时间的影响因素分析. 安徽医科大学学报. 2022(04): 645-649 .
10.	王玮，陈熙，罗丹，李启祥，尹合坤. 不同姑息性引流术对低位恶性梗阻性黄疸的近远期疗效及安全性分析. 当代医学. 2022(19): 39-42 .
11.	买买提·瓦司力，高旭升，司俊杰，徐峰. 经皮肝穿引流和支架植入在恶性梗阻性黄疸患者治疗的疗效评价. 新疆医学. 2022(07): 770-772+809 .
12.	王颖. 彩超引导经皮穿刺肝胆管引流术治疗梗阻性黄疸的临床研究. 中国医疗器械信息. 2022(15): 123-125 .
13.	宋飞，向盈盈，车佳音，李红阳，徐文勇，魏凌潇，黄明. 胆道~(125)I粒子支架与金属裸支架治疗Bismuth Corlette Ⅲ型胆管癌合并梗阻性黄疸的临床对比. 昆明医科大学学报. 2022(11): 85-89 .
14.	冉庆. ERCP联合PTCD胆总管支架置入胆管引流治疗恶性梗阻性黄疸的临床价值. 医学食疗与健康. 2021(04): 86-87 .
15.	王锦程，余佩和，苏松，李波. 经内镜鼻胆管引流术与经内镜胆道支架置入术在低位恶性梗阻性黄疸术前胆道引流效果比较的Meta分析. 临床肝胆病杂志. 2021(04): 863-867 . 本站查看
16.	马博，周军，周京涛，李建刚，王俊. 胆道支架植入治疗恶性梗阻性黄疸术后并发症的发生因素分析. 现代生物医学进展. 2021(07): 1283-1286 .
17.	张建松，侯森，崔虎啸. 超声引导下经皮肝穿刺胆道引流联合胆管复合支架置入术治疗晚期肝外胆管癌的效果. 癌症进展. 2021(09): 931-934 .
18.	张华安，周晓芳，蒋易君，张淏嘉. NRS-2002联合炎症反应标志物预测恶性梗阻性黄疸患者预后的Nomogram模型构建. 山东医药. 2021(16): 35-40 .
19.	石书伟，王劲. 经皮肝穿刺胆道引流联合金属支架植入术对恶性梗阻性黄疸的影响. 黑龙江医学. 2021(15): 1608-1609 .
20.	宋英茜，陶冶. 梗阻性黄疸经皮肝穿刺胆道引流术后胆道感染的病原菌特点及其危险因素分析. 中国实用乡村医生杂志. 2021(02): 33-36 .
21.	张志强，韩涛，崔钢，王奕，蔡恒烈，廖骞. 右肝管入路单通道横跨左右肝管引流治疗汇管区恶性梗阻性黄疸的临床研究. 中国普通外科杂志. 2021(12): 1503-1508 .
22.	傅建英. 内镜介入治疗急性梗阻性黄疸的疗效及对患者炎症因子的影响. 中外医疗. 2021(33): 57-60 .
23.	李蔚，王锡斌，崔卫东，杨青，刘会苗，杨金雨，王锡斌. 超声引导下经皮经肝胆管穿刺引流术治疗急性梗阻性化脓性胆管炎患者疗效分析. 实用肝脏病杂志. 2020(03): 447-450 .
24.	李磊. 胆道支架联合经皮肝穿刺胆管引流术对晚期恶性梗阻性黄疸的临床应用价值. 名医. 2020(08): 85-86 .
25.	张蓓，答秀维，张乐. 经皮肝穿刺胆道外引流治疗恶性梗阻性黄疸疗效及对患者细胞免疫功能、血清直接胆红素、超敏C反应蛋白水平的影响. 陕西医学杂志. 2020(10): 1249-1252 .
26.	朱超，刘会春，胡小四，庞青，陈邦邦，李传涛. 胆道双支架联合~(125)I粒子腔内照射治疗恶性肝门部胆道梗阻的疗效分析. 介入放射学杂志. 2020(11): 1100-1104 .
27.	姜磊，都晓英，孙医学，张大坤，周凯，徐建中，陈芳芳. PTBS术治疗恶性梗阻性黄疸的临床价值及预后因素分析. 蚌埠医学院学报. 2019(09): 1202-1205+1209 .
28.	江新华. 64层螺旋CT3D成像与MRCP成像技术对胆道梗阻性疾病的诊断价值. 江西医药. 2019(11): 1336-1340 .
29.	吴子鑫，吴申伟. 经皮肝穿刺胆道支架植入治疗对恶性梗阻性黄疸患者肝功能指标、炎症指标的影响. 齐齐哈尔医学院学报. 2019(24): 3098-3099 .
30.	武飞. 经皮肝穿刺胆管引流术与Roux-en-Y胆肠吻合术治疗恶性梗阻性黄疸患者的对比研究. 中国药物与临床. 2019(23): 4098-4100 .

Other cited types(4)

Proportional views

Proportional views

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

Figures(2) / Tables(2)

Get Citation

PDF

XML

Article Metrics

Article views (445) PDF downloads(68)

Establishment and evaluation of a multivariate Cox proportional-hazards prediction model for mortality during short-term hospitalization in patients with liver cirrhosis and sepsis

DOI: 10.3969/j.issn.1001-5256.2023.05.014