[Analysis of prognostic factors of and to establish a predictive model for patients with chronic severe hepatitis].
OBJECTIVE
To analyze prognostic factors of and to develop a prognostic model for patients with chronic severe hepatitis (CSH).


METHODS
From December 1998 to October 2003, 385 in-patients being treated for chronic severe hepatitis were evaluated. The main clinical and laboratory variables were analyzed as predictive factors of survival with Cox univariate and multivariate regression models.


RESULTS
The median survival time of this study group was 47 days. The survival rates at 1, 3, 6 months, 1-year, and 3 years were 66.2%, 32.9%, 26.9%, 22.9% and 17.7% respectively. Four prognostic factors were extracted using Cox's proportional hazard model; the prognostic index (PI) was calculated using the following formula consisting of these factors. PI = 0.016loge + 1.148 hepatic encephalopathy + 0.294loge (bilirubin micromol/L) - 0.826loge (prothrombin time activity). The model accurately predicted 3 months survival in an independent series of 84 patients with chronic severe hepatitis.


CONCLUSIONS
The developed model is valuable in prognostic evaluation of chronic severe hepatitis and it may be useful to guide clinicians in selecting treatment methods for CSH.
Zhang
Nan
N
Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Wang
Yu-ming
YM
Deng
Guo-hong
GH
Yi
Dong
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D005260:Female; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index