Multi-factor Analysis of the Short-term Prognosis of Patients with Liver Function Failure and the Interaction Effect of Age on Prognosis
To investigate the factors influencing the short-term prognosis of patients with liver function failure and to explore the in-teraction between age and related factors on prognosis.Patients with liver function failure admitted to Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine were retrospectively analyzed between June 2020 and May 2022.The patients'demographic characteristics,complications and laboratory examination indicators were collected on admission,and univariate and binary logistic re-gression analyses were performed to identify the factors affecting the prognosis of liver failure patients.The model's efficacy was evalua-ted using the receiver operating characteristic(ROC)curve,and R language was used to analyze the interaction between age and inde-pendent risk factors on prognosis.The results show that a total of 371 patients are included,with 257(69.27%)in the good prognosis group after 2 weeks of treatment and 114(30.73%)in the poor prognosis group.Univariate screening identifies several possible influ-encing factors,including the number of complications,hepatic encephalopathy,minimum bile acid value,bile acid change rate,mini-mum and maximum values of direct bilirubin,direct bilirubin change rate,creatinine,and blood urea nitrogen(P<0.1).Binary lo-gistic regression analysis show that the number of complications[1.287(95%confidence interval(CI):1.049～1.58),P =0.016],minimum bile acid value[1.007(95%CI:1～1.013),P =0.007],minimum value of direct bilirubin[1.008(95%CI:1.001～1.014),P =0.015],creatinine[1.008(95%CI:1.001～1.016),P =0.028],C-reactive protein(CRP)[1.012(95%CI:1～1.025),P =0.047],and hepatic encephalopathy[4.509(95%CI:2.469～8233),P<0.001]are independent factors affecting the prognosis of patients with liver failure(P<0.05).The ROC curve shows that the critical value of the number of complications is 2.5,with an area under the curve(AUC)of 0.713(95%CI:0.656～0.771).The critical value of minimum bile acid value is 57.8 μmol/L,with an AUC of 0.607(95%CI:0.546～0.668).The critical value of minimum value of direct bilirubin is 71.05 μmol/L,with an AUC of 0.705(95%CI:0.648～0.762).The critical value of creatinine is 77.5 μmol/L,with an AUC of 0.585(95%CI:0.522～0.649).And the critical value of CRP is 22.99 mg/L,with an AUC of 0.550(95%CI:0.484～0.615).The combined prediction factor has an AUC of 0.809,sensitivity is 66.7%,and specificity is 83.7%,age,minimum bile acid value,minimum value of direct bilirubin,and hepatic encephalopathy has a synergistic effect on prognosis.In conclusion,the Logistic regression model constructs based on the number of complications,minimum bile acid value,minimum value of direct bilirubin,creatinine,and hepatic encephalopathy of patients with liver function failure has good predictive classification ability.Patients with advanced age,high bile acid,low minimum value of direct bilirubin,high creatinine,and hepatic encephalopathy may have a higher risk of poor prognosis.
万方数据
维普
