[Prognostic analysis and establishment of a prognostic model for patients with liver failure with hepatorenal syndrome].

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi

Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China.

Published: April 2012

Objective: To identify the factors that may influence the prognosis of patients with hepatorenal syndrome and try to establish a prognostic model.

Methods: Data of 126 patients with hepatorenal syndrome were analyzed and 56 indexes that might affect the prognosis were focused on, involving history, symptoms, signs and lab findings. Cox model and Kaplan-Meier survival analysis were used.

Results: Many factors were found to affect the prognosis independently, including hepatic encephalopathy (HE) and its degree, gastrointestinal bleeding (GIB), blood neutrophil count (N1) and serum creatinine (Cr). The prognosis model was established as the following equation where PI represents prognosis index: PI = 0.711HE + 0.836GIB + 0.052N1 + 0.002Cr (GIB: no = 0, yes = 1; HE: no = 0, phase I = 1, phase II = 2, phase II = 3, phase IV = 4). When PI < 1, the average survival time was 42 days; when 1 < or = PI < or = 3, the average survival time was 15 days; when PI > 3, the average survival time was 2 days.

Conclusion: The results obtained from this study may help in estimation of diagnosis, analysis of illness state and evaluation of therapy in clinical work.

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