Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure
Hao Zhang,1,2 Kai Yang,3 Qin Wang,2 Lei Jin,4 Ling-Mei Wang,2 Xing-Yu Fan,2 Xiu Wang,2 Qiang Zhou,2 Yuan-Hong Xu1 1Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China; 2Department of Clinical Laboratory, Second Af...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-05-01
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| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/prealbumin-as-a-predictor-of-short-term-prognosis-in-patients-with-hbv-peer-reviewed-fulltext-article-IDR |
| _version_ | 1797834941975756800 |
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| author | Zhang H Yang K Wang Q Jin L Wang LM Fan XY Wang X Zhou Q Xu YH |
| author_facet | Zhang H Yang K Wang Q Jin L Wang LM Fan XY Wang X Zhou Q Xu YH |
| author_sort | Zhang H |
| collection | DOAJ |
| description | Hao Zhang,1,2 Kai Yang,3 Qin Wang,2 Lei Jin,4 Ling-Mei Wang,2 Xing-Yu Fan,2 Xiu Wang,2 Qiang Zhou,2 Yuan-Hong Xu1 1Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China; 2Department of Clinical Laboratory, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, People’s Republic of China; 3Department of Medical Technology, Anhui Medical College, Hefei, Anhui, 230601, People’s Republic of China; 4Department of Infectious Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, People’s Republic of ChinaCorrespondence: Yuan-Hong Xu, Department of Clinical Laboratory, the First Hospital of Anhui Medical University, No. 218, Jixi Road, Hefei, Anhui, 230022, People’s Republic of China, Email xyhong1964@163.com Qiang Zhou, Department of Clinical Laboratory, the Second Hospital of Anhui Medical University, No. 678, Furong Road, Hefei, 230601, Anhui, People’s Republic of China, Email zhouqiang1973@163.comPurpose: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a serious medical condition with a high short-term mortality rate, making accurate prognostic assessment essential for informed clinical decision-making. In this study, we aimed to develop a simple and effective prognostic model for predicting short-term mortality in patients with HBV-ACLF.Patients and Methods: To achieve our objective, we enrolled both a cross-sectional cohort (n = 291) and a retrospective cohort (n = 185) in this study. We collected laboratory and clinical data from these cohorts and performed univariate and multivariate logistic regression analyses to identify independent predictors of short-term mortality. Subsequently, we developed a novel prognostic score for HBV-ACLF, which was validated and assessed using receiver operating characteristic (ROC) curve analysis to determine its performance.Results: Our analysis revealed that the admission prealbumin (PAB) level was a robust independent predictor of 30-day mortality, with an area under the receiver operating characteristic (AUROC) of 0.760. Moreover, we developed the HIAPP score, a prognostic-score model based on PAB. The HIAPP score was significantly lower in survivors compared to non-survivors (− 2.80± 0.21 vs 0.97± 0.41, P < 0.001). The HIAPP score’s AUROC value was 0.899, which was found to be superior to the MELD score (AUROC = 0.795) and the CLIF-C ACLF score (AUC =0.781) and comparable to the COSSH-ACLF II score (AUC =0.825) for predicting 30-day mortality. These findings were also validated in a separate cohort, further supporting the utility of the HIAPP score as a prognostic tool for HBV-ACLF patients.Conclusion: Our study identifies the admission PAB level as a simple and valuable predictive index for 30-day mortality in HBV-ACLF patients. Furthermore, the HIAPP score, which incorporates PAB, PLT, INR, HE, and age, is an easy-to-use and pragmatic prognostic score in predicting short-term mortality.Graphical Abstract: Keywords: hepatitis B virus related acute on chronic liver failure, short term prognosis, prealbumin, prognostic model |
| first_indexed | 2024-04-09T14:45:35Z |
| format | Article |
| id | doaj.art-5e606c01bf084ef8add6449549b9b714 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-09T14:45:35Z |
| publishDate | 2023-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-5e606c01bf084ef8add6449549b9b7142023-05-02T18:20:12ZengDove Medical PressInfection and Drug Resistance1178-69732023-05-01Volume 162611262383409Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver FailureZhang HYang KWang QJin LWang LMFan XYWang XZhou QXu YHHao Zhang,1,2 Kai Yang,3 Qin Wang,2 Lei Jin,4 Ling-Mei Wang,2 Xing-Yu Fan,2 Xiu Wang,2 Qiang Zhou,2 Yuan-Hong Xu1 1Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China; 2Department of Clinical Laboratory, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, People’s Republic of China; 3Department of Medical Technology, Anhui Medical College, Hefei, Anhui, 230601, People’s Republic of China; 4Department of Infectious Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, People’s Republic of ChinaCorrespondence: Yuan-Hong Xu, Department of Clinical Laboratory, the First Hospital of Anhui Medical University, No. 218, Jixi Road, Hefei, Anhui, 230022, People’s Republic of China, Email xyhong1964@163.com Qiang Zhou, Department of Clinical Laboratory, the Second Hospital of Anhui Medical University, No. 678, Furong Road, Hefei, 230601, Anhui, People’s Republic of China, Email zhouqiang1973@163.comPurpose: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a serious medical condition with a high short-term mortality rate, making accurate prognostic assessment essential for informed clinical decision-making. In this study, we aimed to develop a simple and effective prognostic model for predicting short-term mortality in patients with HBV-ACLF.Patients and Methods: To achieve our objective, we enrolled both a cross-sectional cohort (n = 291) and a retrospective cohort (n = 185) in this study. We collected laboratory and clinical data from these cohorts and performed univariate and multivariate logistic regression analyses to identify independent predictors of short-term mortality. Subsequently, we developed a novel prognostic score for HBV-ACLF, which was validated and assessed using receiver operating characteristic (ROC) curve analysis to determine its performance.Results: Our analysis revealed that the admission prealbumin (PAB) level was a robust independent predictor of 30-day mortality, with an area under the receiver operating characteristic (AUROC) of 0.760. Moreover, we developed the HIAPP score, a prognostic-score model based on PAB. The HIAPP score was significantly lower in survivors compared to non-survivors (− 2.80± 0.21 vs 0.97± 0.41, P < 0.001). The HIAPP score’s AUROC value was 0.899, which was found to be superior to the MELD score (AUROC = 0.795) and the CLIF-C ACLF score (AUC =0.781) and comparable to the COSSH-ACLF II score (AUC =0.825) for predicting 30-day mortality. These findings were also validated in a separate cohort, further supporting the utility of the HIAPP score as a prognostic tool for HBV-ACLF patients.Conclusion: Our study identifies the admission PAB level as a simple and valuable predictive index for 30-day mortality in HBV-ACLF patients. Furthermore, the HIAPP score, which incorporates PAB, PLT, INR, HE, and age, is an easy-to-use and pragmatic prognostic score in predicting short-term mortality.Graphical Abstract: Keywords: hepatitis B virus related acute on chronic liver failure, short term prognosis, prealbumin, prognostic modelhttps://www.dovepress.com/prealbumin-as-a-predictor-of-short-term-prognosis-in-patients-with-hbv-peer-reviewed-fulltext-article-IDRhepatitis b virus-related acute-on-chronic liver failureshort-term prognosisprealbuminprognostic model; |
| spellingShingle | Zhang H Yang K Wang Q Jin L Wang LM Fan XY Wang X Zhou Q Xu YH Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure Infection and Drug Resistance hepatitis b virus-related acute-on-chronic liver failure short-term prognosis prealbumin prognostic model; |
| title | Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure |
| title_full | Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure |
| title_fullStr | Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure |
| title_full_unstemmed | Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure |
| title_short | Prealbumin as a Predictor of Short-Term Prognosis in Patients with HBV-Related Acute-on-Chronic Liver Failure |
| title_sort | prealbumin as a predictor of short term prognosis in patients with hbv related acute on chronic liver failure |
| topic | hepatitis b virus-related acute-on-chronic liver failure short-term prognosis prealbumin prognostic model; |
| url | https://www.dovepress.com/prealbumin-as-a-predictor-of-short-term-prognosis-in-patients-with-hbv-peer-reviewed-fulltext-article-IDR |
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