AIMS65评分预测肝硬化食管胃底静脉曲张破裂出血患者死亡的价值

Value of AIMS65 score in predicting death of liver cirrhosis patients with esophageal and gastric variceal bleeding

目的探讨AIMS65评分在肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric variceal bleeding,EGVB)患者住院死亡中的预测价值。方法回顾性纳入我院2016年1月至2020年12月诊治的378例肝硬化EGVB患者,根据住院期间生存情况分为存活组345例(91.27%)和死亡组33例(8.73%)。通过电子病历系统收集患者入院时临床资料,采用多因素Logistic回归分析EGVB患者住院期间死亡的危险因素。采用ROC曲线分析AIMS65评分预测EGVB患者住院期间死亡的效能。结果单因素分析显示,死亡组中重度腹水、有肝性脑病的比例以及GBS评分、FRS评分、AIMS65评分均高于存活组(P<0.05),年龄、性别、高血压等与存活组比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,GBS评分(OR=1.704,95%CI:1.069~2.717,P=0.026)、FRS评分(OR=1.758,95%CI:1.160~2.663,P=0.008)、AIMS65评分(OR=1.868,95%CI:1.228~2.842,P=0.002)是肝硬化EGVB患者住院期间死亡的危险因素。ROC曲线分析显示,AIMS65评分预测EGVB患者住院期间死亡的AUC为0.836(95%CI:0.781~0.891),敏感性为72.73%,特异性为82.03%。结论AIMS65评分升高是肝硬化EGVB患者住院期间死亡的危险因素,可预测该类人群短期死亡风险。

Objective To investigate the predictive value of AIMS65 score in the death of liver cirrhosis patients with esophageal and gastric variceal bleeding(EGVB).Methods 378 liver cirrhosis patients with EGVB diagnosed and treated in our hospital from Jan.2016 to Dec.2020 were retrospectively enrolled.According to the survival during hospitalization,they were divided into survival group(345 cases,91.27%)and death group(33 cases,8.73%).Clinical data of patients at admission were collected by electronic medical record system,and risk factors for death during hospitalization of EGVB patients were analyzed by Logistic regression.ROC curve was used to analyze the efficacy of AIMS65 score in predicting death during hospitalization of EGVB patients.Results Univariate analysis showed that the proportion of moderate to severe ascites,hepatic encephalopathy,GBS score,FRS score and AIMS65 score in the death group were higher than those in the survival group(P<0.05),while there were no significant differences in age,gender and hypertension between the death group and the survival group(P>0.05).Multivariate Logistic regression analysis showed that GBS score(OR=1.704,95%CI:1.069-2.717,P=0.026)and FRS score(OR=1.758,95%CI:1.160-2.663,P=0.008)and AIMS65 score(OR=1.868,95%CI:1.228-2.842,P=0.002)were risk factors for death in liver cirrhosis patients with EGVB during hospitalization.ROC curve analysis showed that AIMS65 score predicted the death of EGVB patients during hospitalization with AUC of 0.836(95%CI:0.781-0.891),sensitivity of 72.73%,specificity of 82.03%.Conclusion Increased AIMS65 score is a risk factor for death during hospitalization in liver cirrhosis patients with EGVB,which can effectively predict the short-term risk of death in this population.