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]	Yuanqin DU, Meng WANG, Guochu HUANG, Chun YAO, Ruixi ZHONG, Liangjiang HUANG, Jian XU, Jingjing HUANG, Qinwen TAN, Dewen MAO. Therapeutic effect of retention enema with compound rhubarb decoction on a rat model of minimal hepatic encephalopathy based on bile acid metabolomics[J]. Journal of Clinical Hepatology, 2023, 39(10): 2348-2357. doi: 10.3969/j.issn.1001-5256.2023.10.012
[2]	Yebei LIANG, Chunguang YANG, Huadong ZENG, Ruwei TAO, Qiuming HU, Xiaoying TANG, Huaxiang SHI, Wei WU, Xuhong HOU, Weiping JIA. Establishment of screening models for nonalcoholic fatty liver disease in the adult Blang population[J]. Journal of Clinical Hepatology, 2021, 37(12): 2861-2868. doi: 10.3969/j.issn.1001-5256.2021.12.025
[3]	Ruan JingSheng, Chen Chuang, Li KeZhi, Huang Shan, He JianBo, Ceng AiPing, Lian Fang, Wu GuoBin. Expression and significance of semaphorin 3A and its receptor NRP-1 in a rat model of chronic hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2020, 36(6): 1334-1341. doi: 10.3969/j.issn.1001-5256.2020.06.029
[4]	Lin DongYi, Peng Bo, Zheng JingHui, Wang ZongYu, Li HanZhong, He JianBo, Li KeZhi, Wu GuoBin, Chen Chuang. Value of a logistic regression model based on the clinical features of liver cancer in judging the traditional Chinese medicine syndrome types of primary liver cancer[J]. Journal of Clinical Hepatology, 2020, 36(6): 1293-1298. doi: 10.3969/j.issn.1001-5256.2020.06.021
[5]	Gong Man, Zhou Chao, Zhang Ning, Sun KeWei, Zhang ZhenGang, Li HanMin, Li XiuHui, Yang HongZhi, Li Qin, Wang Lin, Zhou XiaoZhou, Mao DeWen, Guo JianChun, Zhuo YunHui, Wang XianBo, Deng Xin, Wang JieFei, Cao WuKui, Zhang ShuQin, Zhang MingXiang, Li Yun. Clinical effect of integrated traditional Chinese and Western medicine therapy in patients with hepatitis B virus-related acute-on-chronic liver failure complicated by hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2018, 34(4): 795-800. doi: 10.3969/j.issn.1001-5256.2018.04.020
[6]	Wang FengJiao, Liu MingJiang, Wu RuiHong, Niu JunQi. A multivariate logistic regression analysis of short-term prognosis of patients with hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2017, 33(4): 711-714. doi: 10.3969/j.issn.1001-5256.2017.04.022
[7]	Hu LiHua, Chen Peng, Wang XiaoLi, Zhang JiYe, Su LianMing, Zhang PeiYi. Relationship between zonula occludens-1 and blood-brain barrier permeability in rats with hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2015, 31(4): 582-584. doi: 10.3969/j.issn.1001-5256.2015.04.025
[8]	Gu LiLi, Wang XianBo. Research progress in noninvasive regression models for liver fibrosis in patients with chronic hepatitis B[J]. Journal of Clinical Hepatology, 2014, 30(7): 691-694. doi: 10.3969/j.issn.1001-5256.2014.07.032
[9]	Wang GuangYi, Shi XiaoJu, Jiang Chao, Sun XiaoDong, Qiu Wei, Lu: GuoYue. One case of liver transplantation for liver failure due to adult- onset Still's disease[J]. Journal of Clinical Hepatology, 2014, 30(1): 67-68. doi: 10.3969/j.issn.1001-5256.2014.01.018
[10]	Gao Rui, Liu ZhongJing, Chen Fei, Gao Lei, Jiang ChuanWu. Multivariate regression analysis of risk factors for HBV-related primary liver cancer[J]. Journal of Clinical Hepatology, 2014, 30(4): 370-372. doi: 10.3969/j.issn.1001-5256.2014.04.021
[11]	Zhang ZhanQing, Lu Wei, Wang YanBing, Jia XiaoFang, Zhang LiJun, Ding RongRong, Zhou XinLan, Feng YanLing. Diagnosis of hepatic fibrosis in hepatitis B patients by logistic regression modeling based on plasma amino acid ratio and age[J]. Journal of Clinical Hepatology, 2013, 29(5): 330-335.
[12]	Zhang WenHua, Jia WenLing, Zhou ZiYing, Tang HaiTao, Wang FengMei. Investigation on the method and safety of the non-heparinized plasma exchange therapy in treating patients with hepatic failure[J]. Journal of Clinical Hepatology, 2012, 28(1): 50-52.
[13]	Zhou XinMin, Dong XuYang. Therapeutic strategies of liver failure for clinical cases[J]. Journal of Clinical Hepatology, 2012, 28(2): 93-98.
[14]	Zhang AiMin, Xin ShaoJie. Virus infection and liver failure[J]. Journal of Clinical Hepatology, 2012, 28(10): 729-731.
[15]	Xu DaHai, Zhang Nan, Gao JinYing, Wu Yang. The therapeutic development of hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2011, 27(2): 218-221.
[16]	Jiang Hao, Xie Qing. Advances in the diagnosis and treatment of hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2011, 27(10): 1027-1031.
[17]	Wang YuMing, Yan ZeHui. The new concepts on hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2010, 26(6): 568-574.
[18]	Li ShuangXing, Shi LiJun, Wang XiuJie. Effects of bone marrow mesenchymal stem cells transplantation into rats with acute liver failure[J]. Journal of Clinical Hepatology, 2010, 26(6): 624-626.
[19]	Liang Jing, Kan ZhiChao, Zhang JianDong. The clinical characteristics and treatment of liver failure patients with spontaneous bacterial peritonitis[J]. Journal of Clinical Hepatology, 2010, 26(6): 621-623.

Supplements(0)

Cited By

Cited by

Periodical cited type(25)

1.	陈炜. 终末期肝病模型联合血清钠评分对肝衰竭患者短期预后的预测价值. 川北医学院学报. 2024(02): 247-251 .
2.	王学英. MELD-Na评分联合NLR预测肝硬化食管胃静脉曲张破裂出血后再出血的临床价值. 罕少疾病杂志. 2024(05): 70-72 .
3.	林小洪，吴文楠，荀振. 血小板-白蛋白-胆红素评分与肝硬化患者肝功能Child-Turcotte-Pugh分级的相关性分析. 福建医科大学学报. 2024(01): 37-43 .
4.	孙玉，秦维，王丹，郑艳丽，霍玉玲. 前白蛋白及纤维蛋白原水平与代偿期肝硬化食管静脉曲张发生的关系. 中国肝脏病杂志(电子版). 2024(02): 7-12 .
5.	石红. 延续性护理服务方案对肝硬化食管胃静脉曲张内镜下精准断流术后的临床影响研究. 基层医学论坛. 2024(20): 114-116+142 .
6.	李欣忆，李娇娇，孙蔚. 肝硬化食管胃底静脉曲张破裂出血患者经颈静脉肝内门体分流术后发生显性肝性脑病的列线图预测模型建立及评价. 临床肝胆病杂志. 2024(08): 1605-1611 . 本站查看
7.	杨丹，周健. 多种无创预测模型在肝硬化门静脉高压中的研究进展. 中国临床研究. 2024(11): 1778-1783 .
8.	陈刚，谷光丽，何映雪，唐尧. 血清表皮生长因子对肝硬化食管胃静脉曲张患者再出血的诊断价值分析. 转化医学杂志. 2024(10): 1698-1702 .
9.	喻雪珂，黎孟玲，彭思远，申月明，梁纶熙，曾亚. 食管胃底静脉曲张破裂出血对肝硬化患者1年死亡结局的影响及相关因素研究. 中国全科医学. 2023(14): 1745-1752 .
10.	郝艳萍，韩靓，仇晶辉，滕圣智，王建华. 乙肝肝硬化食管胃静脉曲张急性出血患者内镜下治疗后发生菌血症的危险因素分析. 中国消毒学杂志. 2023(03): 182-184 .
11.	顾达，童聪，赵祥安，向晓星. PC/SD、FIB-4指数、CTP评分、MELD评分、MELD-Na评分在预测肝硬化食管静脉曲张出血套扎术后1年内再出血的价值评估. 胃肠病学和肝病学杂志. 2023(03): 289-294 .
12.	朱会明，张华，张金荣，吴雪华，吴柳，刘义安. 肝硬化血瘀证患者食管胃底静脉曲张相关性研究. 中国中医急症. 2023(04): 665-668 .
13.	周苏云，周影，程新月. 肝硬化患者发生肝性脑病的影响因素分析及对预检分诊意义的探讨. 中西医结合护理(中英文). 2023(03): 130-132 .
14.	葛琴. 血府逐瘀汤联合双歧杆菌三联活菌治疗酒精性肝硬化的疗效研究. 中医临床研究. 2023(20): 142-145 .
15.	邱荣金，卢劲瑜，苏雪梅，郑凤祥，廖丽芳. 预防使用抗生素对食管胃静脉曲张内镜下治疗的影响评估. 中国现代药物应用. 2023(19): 99-101 .
16.	邢恩涛，赵孟杰，金鹏飞，武振东，刘志春. 肝硬化门静脉高压TIPS术后HVPG下降相关因素. 青岛大学学报(医学版). 2023(05): 759-762 .
17.	刘媛，徐建光，何雪云，万秀萍，林小花，王莉娟，郑临海. 血钙浓度联合MELD评分对肝硬化严重程度的预测价值. 浙江中西医结合杂志. 2022(02): 129-130+149 .
18.	张春燕，田正方，朱经科，晁燕茹. 肝硬化患者食管静脉曲张套扎术后再出血影响因素分析及干预对策. 黑龙江医药科学. 2022(02): 96-99 .
19.	俞斌，屠军，沈玉玲. AIMS65评分预测肝硬化食管胃底静脉曲张破裂出血患者死亡的价值. 胃肠病学和肝病学杂志. 2022(07): 737-742 .
20.	刘益，周自忠，刘刚，徐海荣. 食管胃底静脉曲张破裂出血患者急诊TIPS术后肝性脑病发生特征及危险因素分析. 肝脏. 2022(06): 658-661 .
21.	廖翔. 肝硬化患者SAAG与食管胃底静脉曲张破裂出血的关系研究. 现代诊断与治疗. 2022(11): 1646-1648+1692 .
22.	张春燕，田正方，朱经科，晁燕茹. 肝硬化患者食管静脉曲张套扎术后再出血影响因素分析. 黑龙江医药科学. 2022(05): 171-173 .
23.	曾伍姣，张知洪，陈令民，李亦明. 血管紧张素Ⅱ水平在肝硬化患者诊断中的应用及与MELD评分关系研究. 肝胆外科杂志. 2021(01): 60-63 .
24.	祝强，杨继敏，刘中亮. 八种评分系统对肝硬化失代偿期患者短期预后的预测价值. 中国医药科学. 2021(19): 18-22 .
25.	赵媛，赵明，范玉梅，邵建营. 失代偿期乙型肝炎肝硬化患者不同病毒学应答状态对生存率及肝癌患病率的影响. 中国实用医刊. 2020(23): 50-52 .

Other cited types(9)

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 (447) 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