Objective To investigate the relationship between pan-immune inflammatory value(PIV)and prognosis in elderly patients with Hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods Two hundred and fifteen elderly HBV-ACLF patients admitted to our hospital from January 2022 to December 2023 were followed up for 3 months.According to the baseline PIV the patients were divided into high PIV group(≥405.31)andlow PIV group(＜405.31).Prognosis was evaluated and the factors affecting the prognosis were analyze with multivariate logistic regression.Results The model for end-stage liver disease score(MELD score),white blood cell count(WBC),total bilirubin(TBIL),procalcitonin(PCT),interleukin-6(IL-6),serum amyloid A(SAA)in high PIV group were higher than those in low PIV group(P＜0.05).Seventy-seven patients(13.6％)died during the follow-up period in the 2 groups.Kaplan Meier analysis showed that the mortality rate of patients in the high PIV group was significantly higher than that in the low PIV group(P＜0.05).The AUC(95％CI)of PIV in evaluating the prognosis of elderly HBV-ACLF patients was 0.916(0.861～0.951),the sensitivity was 87.38％,and the specificity was 84.56％(P＜0.05).MELD score,PCT,IL-6 and PIV of elderly HBV-ACLF patients were related to their prognosis(P＜0.05).MELD score≥31.13(HR=2.807,95％CI:1.523～5.173),PCT ≥ 0.81 ng/mL(HR=2.614,95％CI:1.294～5.284),IL-6 ≥ 24.86 μg/mL(HR=2.351,95％CI:1.345～4.111),PIV≥436.75(HR=3.384,95％CI:1.807～6.336)was the prognotic factor of elderly HBV-ACLF patients(P＜0.05).Conclusion High PIV is an independent risk factor affecting the prognosis of HBV-ACLF patients,and it may have clinical value in prognosis judgment.
acute-on-chronic liver failurehepatitis B viruspan-immune inflammatory valueprognosis
维普
万方数据
