[Model for predicting survival of patients with severe virus hepatitis and its clinical application].

Objective: To study prospectively the short-time survival of patients with severe virus hepatitis using model of severe liver diseases (MSLD) established by our previous study.

Methods: One hundred and three patients with severe hepatitis were included by cohort study. Of them, there were 85 patients with severe chronic hepatitis patients, 10 acute and 8 subacute severe hepatitis patients, respectively. The follow-up endpoint was 6 months. The cutoff score of the MSLD was determined by receiver operating characteristic cure (ROC) statistic analysis, and the survival of severe hepatitis patients in 2 weeks, 4 weeks, 3 months and 6 months were estimated by Kaplan-Meier statistic analysis.

Results: The cutoff MSLD score for predicting survival was 5. The survival curves of group A (total MSLD score< or =4) was significantly better than group B (total MSLD score> or =5, P<0.000). After treatment for 2 weeks, the survival rate in 2 weeks and 4 weeks was 37.9% and 3.5%, respectively, if MSLD score had no change or increased. The survival rate in 2 weeks, 4 weeks and 3 months was respectively 61.5%, 15.4%, 5.8% if the MSLD score decreased 1. Then, the survival in 2 weeks, 4 weeks, 3 months and 6 months was respectively 95.0%, 90.0%, 63.9% and 52.4% if MSLD score decreased 2 or more.

Conclusion: It is suggested that MSLD may be valuable in predicting 6-month survival of severe virus hepatitis patients. It may be used to determine the efficacy of medical treatment and to guide clinical decision.