Low platelet to high-density lipoprotein ratio predicts poor short-term prognosis in hepatitis B-related acute-on-chronic liver failure.

BMC Infect Dis

Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17, Yongwaizhengjie Road, Donghu District Nanchang 330006, Nanchang, Jiangxi, China.

Published: August 2024

AI Article Synopsis

  • Acute-on-chronic liver failure (ACLF), mainly linked to hepatitis B in the Asia-Pacific, has a high short-term mortality rate, prompting a study on the platelet to high-density lipoprotein ratio (PHR) as a prognostic tool.
  • A retrospective analysis of 270 HBV-ACLF patients revealed that a low PHR was significantly associated with higher mortality within 28 days, indicating its potential as a predictive factor.
  • The developed prognostic model based on PHR outperformed traditional scores like Child-Turcotte-Pugh, showcasing its clinical utility in predicting short-term mortality in these patients.*

Article Abstract

Background: Acute-on-chronic liver failure (ACLF) is characterized by a systemic inflammatory response, predominantly associated with hepatitis B virus in the Asia-Pacific region, with a high short-term mortality rate. The platelet to high-density lipoprotein ratio (PHR) has been used to predict the prognosis of patients with various inflammatory diseases. We aim to is to use the PHR to predict the short-term prognosis of patients with HBV-ACLF.

Method: In this study, we retrospectively analyzed clinical data from 270 HBV-ACLF patients. Using logistic regression, we identified independent risk factors for short-term mortality and developed a prognostic model. This model was then validated, compared, and its clinical utility assessed via decision curve analysis (DCA).

Results: Among the 270 HBV-ACLF patients, 98 patients died within 28 days. The deceased group exhibited a higher proportion of severe hepatic encephalopathy and ascites. Additionally, there was a statistically significant difference (P = 0.046) in the novel inflammation scoring system, PHR, between the two groups. Following stringent variable selection, PHR was identified as a predictive factor for short-term mortality in HBV-ACLF patients using logistic regression analysis (OR: 0.835 (0.756-0.999), P = 0.009), and it exhibited a synergistic effect with certain traditional scores. The prognostic model constructed based on PHR demonstrated a superior ability to predict short-term mortality compared to traditional scores such as Child-Turcotte-Pugh (AUC: 0.889). Evaluation using calibration curves and decision curve analysis (DCA) suggested its practical utility.

Conclusion: PHR can predict short-term mortality in patients, with a low PHR upon admission being associated with an increased risk of death.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363422PMC
http://dx.doi.org/10.1186/s12879-024-09769-0DOI Listing

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