摘要
目的探究AIMS65评分与格拉斯哥-布拉奇福德(GBS)评分联合红细胞分布宽度(RDW)预测肝硬化食管胃底静脉曲张破裂出血(EGVB)患者院内死亡的临床价值,以期为此类患者的早期干预提供参考。方法回顾性纳入2016年6月—2022年6月在哈尔滨医科大学附属第一医院消化内科住院治疗的396例肝硬化EGVB患者,根据住院期间是否死亡,分为死亡组36例、存活组360例。通过住院患者电子病历系统收集两组患者的临床资料,采用多因素logistic回归分析筛选肝硬化EGVB住院死亡的独立危险因素;采用ROC曲线分析AIMS65评分联合RDW预测肝硬化EGVB院内死亡的临床价值。结果将单因素分析中差异有统计学意义的肝性脑病比例、RDW、血小板、C反应蛋白、终末期肝病模型(MELD)评分、GBS评分、AIMS65评分作为自变量纳入多因素logistic回归分析,肝性脑病、RDW>14.50%、GBS评分>10.65分、AIMS65评分>3.35分,是肝硬化EGVB患者住院死亡的独立危险因素(P<0.05)。ROC曲线显示,AIMS65评分联合RDW预测肝硬化EGVB患者住院死亡的AUC为0.857,综合性能优于GBS评分联合RDW。结论AIMS65评分、RDW升高是肝硬化EGVB患者院内死亡的独立危险因素,两者联合应用对于预测其院内全因死亡风险具有较高的临床价值。
Objective To investigate the clinical value of AIMS65 score and Glasgow-Blatchford(GBS)score combined with red blood cell distribution width(RDW)in predicting in-hospital death in patients with esophageal and gastric variceal bleeding(EGVB)in cirrhosis with a view to providing a reference for early intervention in such patients.Methods A total of 396 patients with cirrhotic EGVB who were hospitalised in the Department of Gastroenterology of the First Affiliated Hospital of Harbin Medical University from June 2016 to June 2022 were retrospectively included and divided into death group(n=36)and survival group(n=360)according to whether they died during hospitalization.The clinical data of the two groups was collected by electronic medical record system,multivariate logistic regression analysis was used to screen the independent risk factors of in-hospital death of EGVB in liver cirrhosis;ROC curve analysis was used to analyze the clinical value of AIMS65 score combined with RDW in predicting in-hospital death of EGVB in liver cirrhosis.Results The proportion of hepatic encephalopathy,RDW,platelets,C-reactive protein,model for end-stage liver disease(MELD)score,GBS score,and AIMS65 score that were significantly different in univariate analysis were included as independent variables in multivariate logistic regression analysis,and hepatic encephalopathy,RDW>14.50%,GBS score>10.65 points,and AIMS65 score>3.35 points were independent risk factors for in-hospital death in cirrhotic EGVB patients(P<0.05).ROC curve showed that the AUC of AIMS65 score combined with RDW in predicting in-hospital death in cirrhotic EGVB patients was 0.857,and the comprehensive performance was better than that of GBS score combined with RDW.Conclusion AIMS65 score and elevated RDW are independent risk factors for in-hospital death in cirrhotic patients with EGVB,and the com-bination of the two has a high clinical value for predicting the risk of in-hospital all-cause death.
作者
韩瑜
孙瑶
张超
马丽
Han Yu;Sun Yao;Zhang Chao;Ma Li(Department of Gastroenterology,the First Affiliated Hospital of Harbin Medical University,Harbin 150000)
出处
《国际老年医学杂志》
2024年第1期69-75,共7页
International Journal of Geriatrics
基金
黑龙江省自然科学基金项目(YQ2020H018)。
关键词
肝硬化
食管胃底静脉曲张破裂出血
红细胞分布宽度
住院死亡
Liver cirrhosis
Esophageal and gastric variceal bleeding
Red cell distribution width
Death in hospital
