Prognostic factors for chronic severe hepatitis and construction of a prognostic model.
BACKGROUND
Chronic severe hepatitis is a serious illness with a high mortality rate. Discussion of prognostic judgment criteria for chronic severe hepatitis is of great value in clinical guidance. This study was designed to investigate the clinical and laboratory indices affecting the prognosis of chronic severe hepatitis and construct a prognostic model.


METHODS
The clinical and laboratory indices of 213 patients with chronic severe hepatitis within 24 hours after diagnosis were analyzed retrospectively. Death or survival was limited to within 3 months after diagnosis.


RESULTS
The mortality of all patients was 47.42%. Compared with the survival group, the age, basis of hepatocirrhosis, infection, degree of hepatic encephalopathy (HE) and the levels of total bilirubin (TBil), total cholesterol (CHO), cholinesterase (CHE), blood urea nitrogen (BUN), blood creatinine (Cr), blood sodium ion (Na), peripheral blood leukocytes (WBC), alpha-fetoprotein (AFP), international normalized ratio (INR) of blood coagulation and prothrombin time (PT) were significantly different in the group who died, but the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB) and hemoglobin (HGB) were not different between the two groups. At the same time, a regression model, Logit (P) =1.573XAge+1.338XHE-1.608XCHO+0.011XCr-0.109XNa+1.298XINR+11.057, was constructed by logistic regression analysis and the prognostic value of the model was higher than that of the MELD score.


CONCLUSIONS
Multivariate analysis excels univariate analysis in the prognosis of chronic severe hepatitis, and the regression model is of significant value in the prognosis of this disease.
Li
Qian
Q
Intensive Care Unit, Tianjin Infectious Diseases Specialty Hospital, Tianjin 300193, China. l191an@126.com
Yuan
Gui-Yu
GY
Tang
Ke-Cheng
KC
Liu
Guo-Wang
GW
Wang
Rui
R
Cao
Wu-Kui
WK
D000328:Adult; D017677:Age Distribution; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006454:Hemoglobins; D006521:Hepatitis, Chronic / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012709:Serum Albumin; D012720:Severity of Illness Index; D017678:Sex Distribution
D006454:Hemoglobins; D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase