Correlation and prognostic accuracy between noninvasive liver fibrosismarkers and portal pressure in cirrhosis: Role of ALBI score

被引:32
作者
Hsieh, Yun-Cheng [1 ,2 ]
Lee, Kuei-Chuan [1 ,2 ]
Wang, Ying-Wen [2 ,3 ]
Yang, Ying-Ying [2 ,4 ]
Hou, Ming-Chih [1 ,2 ]
Huo, Teh-Ia [1 ,2 ,5 ]
Lin, Han-Chieh [1 ,2 ]
机构
[1] Taipei Vet Gen Hosp, Div Gastroenterol & Hepatol, Dept Med, Taipei, Taiwan
[2] Natl Yang Ming Univ, Fac Med, Sch Med, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Healthcare & Serv Ctr, Taipei, Taiwan
[4] Taipei Vet Gen Hosp, Dept Med Educ, Taipei, Taiwan
[5] Natl Yang Ming Univ, Inst Pharmacol, Sch Med, Taipei, Taiwan
关键词
IN-HOSPITAL MORTALITY; LONG-TERM PROGNOSIS; HEPATOCELLULAR-CARCINOMA; HEMODYNAMIC-RESPONSE; HYPERTENSION; THERAPY; INDEX; PUGH; PREDICTOR; DISEASE;
D O I
10.1371/journal.pone.0208903
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background The role of noninvasive liver fibrosis markers which were developed to evaluate the severity of chronic liver disease remains unclear in cirrhosis. Aims To evaluate the correlation between noninvasive markers and hemodynamic parameters and their prognostic performance in cirrhotic patients. Methods A total of 242 cirrhotic patients undergoing hemodynamic study were analyzed. The correlations between noninvasive models, including FIB-4, aspartate aminotransferase to platelet ratio index, cirrhosis discriminant score, Lok index, Goteborg University Cirrhosis Index, and albumin-bilirubin (ALBI) score and hemodynamic parameters were investigated, along with their predictive accuracy for short- and long-term survival. Results There was a significant correlation between all noninvasive markers and hepatic venous pressure gradient (HVPG), and ALBI score had the best correlation (r = 0.307, p<0.001). For the prediction of 3-month and 6-month mortality, serum sodium (sNa) levels had the highest area under curve (AUC; 0.799 and 0.818, respectively) among all parameters, and ALBI score showed the best performance (AUC = 0.691 and 0.740, respectively) compared with other 5 noninvasive models. Of 159 patients with low MELD scores (<14), high ALBI score (>-1.4) and low sNa (<135 mmol/L) predicted early mortality. In the Cox multivariate model, ALBI, MELD, HVPG and sNa were independent predictors of long-term survival. Conclusions Among noninvasive markers, ALBI score is best correlated with HVPG and associated with short-term outcome in cirrhotic patients. A high ALBI score and low sNa identify high-risk patients with low MELD scores. High MELD, HVPG, ALBI and low sNa levels are independent predictors of survival. Independent studies are required to confirm our findings.
引用
收藏
页数:15
相关论文
共 36 条
[1]   Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis [J].
Abraldes, JG ;
Tarantino, I ;
Turnes, J ;
Garcia-Pagan, JC ;
Rodés, J ;
Bosch, J .
HEPATOLOGY, 2003, 37 (04) :902-908
[2]  
Bonacini M, 1997, AM J GASTROENTEROL, V92, P1302
[3]   Complications of cirrhosis.: I.: Portal hypertension [J].
Bosch, J ;
García-Pagán, JC .
JOURNAL OF HEPATOLOGY, 2000, 32 :141-156
[4]   New simple prognostic score for primary biliary cirrhosis: Albumin-bilirubin score [J].
Chan, Anthony W. H. ;
Chan, Ronald C. K. ;
Wong, Grace L. H. ;
Wong, Vincent W. S. ;
Choi, Paul C. L. ;
Chan, Henry L. Y. ;
To, Ka-Fai .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2015, 30 (09) :1391-1396
[5]   Usefulness of albumin-bilirubin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis [J].
Chen, R. -C. ;
Cai, Y. -J. ;
Wu, J. -M. ;
Wang, X. -D. ;
Song, M. ;
Wang, Y. -Q. ;
Zheng, M. -H. ;
Chen, Y. -P. ;
Lin, Z. ;
Shi, K. Q. .
JOURNAL OF VIRAL HEPATITIS, 2017, 24 (03) :238-245
[6]   Diagnostic and Prognostic Values of Noninvasive Predictors of Portal Hypertension in Patients with Alcoholic Cirrhosis [J].
Cho, Eun Ju ;
Kim, Moon Young ;
Lee, Jeong-Hoon ;
Lee, Il Young ;
Lim, Yoo Li ;
Choi, Dae Hee ;
Kim, Yoon Jun ;
Yoon, Jung-Hwan ;
Baik, Soon Koo .
PLOS ONE, 2015, 10 (07)
[7]   Natural history and prognostic indicators of survival in cirrhosis: A systematic review of 118 studies [J].
D'Amico, G ;
Garcia-Tsao, G ;
Pagliaro, L .
JOURNAL OF HEPATOLOGY, 2006, 44 (01) :217-231
[8]   Predictive value of the variceal pressure response to continued pharmacological therapy in patients with cirrhosis and portal hypertension [J].
Escorsell, A ;
Bordas, JM ;
Castañeda, B ;
Llach, J ;
García-Pagán, JC ;
Rodés, J ;
Bosch, J .
HEPATOLOGY, 2000, 31 (05) :1061-1067
[9]   RELATION BETWEEN PORTAL PRESSURE RESPONSE TO PHARMACOTHERAPY AND RISK OF RECURRENT VARICEAL HEMORRHAGE IN PATIENTS WITH CIRRHOSIS [J].
FEU, F ;
GARCIAPAGAN, JC ;
BOSCH, J ;
LUCA, A ;
TERES, J ;
ESCORSELL, A ;
RODES, J .
LANCET, 1995, 346 (8982) :1056-1059
[10]   THERMODILUTION CARDIAC-OUTPUT DETERMINATION WITH A SINGLE FLOW-DIRECTED CATHETER [J].
FORRESTER, JS ;
GANZ, W ;
SWAN, HJC ;
DIAMOND, G ;
CHONETTE, DW ;
MCHUGH, T .
AMERICAN HEART JOURNAL, 1972, 83 (03) :306-+