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CN 22-1108/R
Volume 39 Issue 6
Jun.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(6): 1308-1312

Value of platelet count and related scoring models in predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2023.06.009
  • 1.

    Department of Gastroenterology, School of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan 646000, China

  • 2.

    Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu 610083, China

  • 3.

    Department of Gastroenterology, The First People's Hospital of Longquanyi District, Chengdu 610100, China

Research funding:

The Science Foundations of Health Commission of Sichuan Province (20PJ180)

More Information
  • Corresponding author: TANG shanhong, tangshanhong@swjtu.edu.cn (ORCID: 0000-0001-6652-2942)
  • Received Date: 2022-11-30
  • Accepted Date: 2022-12-26
  • Published Date: 2023-06-20
    Abstract
  •   Objective  To investigate the association between platelet count (PLT) and the prognosis of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), to establish a new PLT-related scoring model, and to assess its value in predicting the short-term prognosis of HBV-ACLF.  Methods  A retrospective cohort study was conducted among the patients with HBV-ACLF who were hospitalized and treated in Department of Gastroenterology, The General Hospital of Western Theater Command, from January 2018 to January 2022. Clinical data within 24 hours after admission were collected from all patients, and according to the survival after 180 days of follow-up, the patients were divided into survival group and death group. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The Pearson correlation coefficient was used to investigate the correlation between different indicators, and the logistic regression model was used to analyze the influencing factors for prognosis. The receiver operating characteristic (ROC) curve was used to assess the predictive value of the prognostic model, and the Kaplan-Meier curve analysis was used to investigate the survival condition of the high AIP group and the low AIP group.  Results  A total of 236 patients were enrolled, with a 180-day survival rate of 75.85% (179/236). Compared with the survival group, the death group had significantly higher age (53.98±10.45 vs 47.44±12.46, P=0.001), international normalized ratio (INR) [1.78 (1.46-2.04) vs 1.47 (1.23-1.68), P < 0.001], total bilirubin [275.60 (165.00-451.45) vs 230.60 (154.90-323.70), P=0.035], Model for End-Stage Liver Disease (MELD) score [21.47 (18.14-24.76) vs 18.67 (15.70-21.62), P < 0.001], and albumin-bilirubin (ALBI) score [-1.06 (-1.64~-0.86) vs-1.32 (-1.73~-1.01), P=0.034], as well as significantly lower PLT [80.00 (50.00~124.50) vs 115.00 (82.00~143.00), P=0.001] and platelet-to-white blood cell ratio (PWR) [13.40 (9.54~20.70) vs 18.49 (13.95~24.74), P=0.001]. The Pearson correlation analysis showed that PLT was negatively correlated with liver cirrhosis and INR (r=-0.332 and -0.194, P < 0.001 and P=0.003). The multivariate logistic regression analysis showed that age (odds ratio [OR]=1.045, 95% confidence interval [CI]: 1.015-1.076), PLT (OR=0.990, 95%CI: 0.983-0.998), and INR (OR=2.591, 95%CI: 1.363-4.925) were independent risk factors for the 180-day prognosis of HBV-ACLF patients. The new predictive model was established as follows: AIP=0.006×age+0.187×INR-0.001×PLT. The AIP scoring model had an area under the ROC curve (AUC) of 0.718 in predicting the 180-day prognosis of HBV-ACLF patients, with a sensitivity of 81.1% and a specificity of 54.1%, while PLT, PWR, LPACLF score, MELD score, and ALBI score had an AUC of 0.673, 0.659, 0.588, 0.647, and 0.578, respectively. The AIP scoring model had an optimal cut-off value of 0.48. The Kaplan-Meier survival analysis showed that the high AIP group had a significantly lower survival rate than the low AIP group (P < 0.001).  Conclusion  The PLT-related scoring model has a better value than other models in predicting the prognosis of HBV-ACLF, and HBV-ACLF patients with a relatively high PLT level tend to have a high overall survival rate.

     

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    • References(12)
  • [1]
    ARROYO V, MOREAU R, JALAN R. Acute-on-chronic liver failure[J]. N Engl J Med, 2020, 382(22): 2137-2145. DOI: 10.1056/NEJMra1914900.
    [2]
    LISMAN T, PORTE RJ. Mechanisms of platelet-mediated liver regeneration[J]. Blood, 2016, 128(5): 625-629. DOI: 10.1182/blood-2016-04-692665.
    [3]
    ARYAL B, YAMAKUCHI M, SHIMIZU T, et al. Therapeutic implication of platelets in liver regeneration -hopes and hues[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(12): 1219-1228. DOI: 10.1080/17474124.2018.1533813.
    [4]
    TAKAHASHI K, LIANG C, ODA T, et al. Platelet and liver regeneration after liver surgery[J]. Surg Today, 2020, 50(9): 974-983. DOI: 10.1007/s00595-019-01890-x.
    [5]
    Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35(1): 38-44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.

    中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35(1): 38-44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
    [6]
    JIE Y, GONG J, XIAO C, et al. Low platelet to white blood cell ratio indicates poor prognosis for acute-on-chronic liver failure[J]. Biomed Res Int, 2018, 2018: 7394904. DOI: 10.1155/2018/7394904.
    [7]
    XU X, HOU Z, XU Y, et al. The dynamic of platelet count as a novel and valuable predictor for 90-day survival of hepatitis B virus-related acute-on-chronic liver failure patients[J]. Clin Res Hepatol Gastroenterol, 2021, 45(2): 101482. DOI: 10.1016/j.clinre.2020.06.008.
    [8]
    GUO J, GONG ZJ, SHI CX. Research progress on hepatitis B virus related acute-on-chronic liver failure with infections[J/CD]. Chin J Liver Dis(Electronic Edition), 2022, 14(3): 5-8. DOI: 10.3969/j.issn.1674-7380.2022.03.002.

    郭金, 龚作炯, 石春霞. 乙型肝炎病毒相关慢加急性肝衰竭合并感染研究进展[J/CD]. 中国肝脏病杂志(电子版), 2022, 14(3): 5-8. DOI: 10.3969/j.issn.1674-7380.2022.03.002.
    [9]
    DUSEJA A, SINGH SP. Toward a better definition of acute-on-chronic liver failure[J]. J Clin Exp Hepatol, 2017, 7(3): 262-265. DOI: 10.1016/j.jceh.2017.05.002.
    [10]
    GAO XY, CHEN L, GAN JH. Value of Model for End-Stage Liver Disease score combined with platelet-to-white blood cell ratio in predicting the prognosis of patients with hepatitis B virus-associated acute-on-chronic liver failure[J]. J Clin Hepatol, 2021, 37(5): 1070-1074. DOI: 10.3969/j.issn.1001-5256.2021.05.019.

    高心怡, 陈丽, 甘建和. MELD评分联合血小板/白细胞比值对HBV相关慢加急性肝衰竭患者预后的预测价值[J]. 临床肝胆病杂志, 2021, 37(5): 1070-1074. DOI: 10.3969/j.issn.1001-5256.2021.05.019.
    [11]
    SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update[J]. Hepatol Int, 2019, 13(4): 353-390. DOI: 10.1007/s12072-019-09946-3.
    [12]
    SHI Y, YANG Y, HU Y, et al. Acute-on-chronic liver failure precipitated by hepatic injury is distinct from that precipitated by extrahepatic insults[J]. Hepatology, 2015, 62(1): 232-242. DOI: 10.1002/hep.27795.
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