AIMS65评分和中性粒细胞淋巴细胞比值与老年肝硬化食管胃底静脉破裂出血患者住院期间死亡的相关性

Correlation of AIMS65 Score and Neutrophil-to-lymphocyte Ratio with Death during Hospitalisation in Elderly Patients with Ruptured Esophagogastric Vein Haemorrhage in Cirrhosis

目的 评估AIMS65评分联合中性粒细胞淋巴细胞比值(NLR)预测肝硬化食管胃底静脉破裂出血(EGVB)住院死亡的可行性,旨在辅助临床进行患者管理。方法 选取2018年1月—2022年10月在南京医科大学附属泰州人民医院住院治疗的326例肝硬化EGVB患者为研究对象。根据住院期间转归情况分为死亡组33例、生存组293例。通过电子病历收集所有患者的临床资料,采用多因素logistic回归法筛选肝硬化EGVB患者住院期间死亡的独立危险因素;采用ROC曲线分析入院时AIMS65评分联合NLR预测EGVB住院期间死亡的临床价值。结果 单因素分析显示,两组白蛋白、NLR、AIMS65评分差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,NLR、AIMS65评分是肝硬化EGVB患者院内死亡的独立危险因素(P<0.05)。ROC曲线分析显示,AIMS65联合NLR预测肝硬化EGVB患者院内死亡的效能高于单一AIMS65、NLR,预测效能最高,差异有统计学意义(P<0.05)。结论 AIMS65评分联合NLR可预测肝硬化EGVB患者院内死亡风险,为此类患者危险分层以及个体化干预提供了思路。

Objective To evaluate the feasibility of AIMS65 score combined with neutrophil-to-lymphocyte ratio(NLR)in predicting in-hospital death from esophageal and gastric variceal bleeding(EGVB)in cirrhosis in order to assist clinical patient management.Methods A total of 326 patients with EGVB due to liver cirrhosis who were hospitalized in Taizhou People′s Hospital Affiliated to Nanjing Medical University from January 2018 to October 2022 were selected as the study subjects.According to the outcome during hospitalization,33 patients were divided into death group and 293 patients into survival group.The clinical data of all patients were collected by electronic medical records,and multivariate logistic regression was used to screen the independent risk factors for in-hospital death in cirrhotic EGVB patients;ROC curve was used to analyze the clinical value of AIMS65 score combined with NLR at admission in predicting in-hospital death in EGVB patients.Results Univariate analysis showed that there were significant differences in albumin,NLR,and AIMS65 scores between the two groups(P<0.05).Multivariate logistic regression analysis showed that NLR and AIMS65 scores were independent risk factors for in-hospital death in cirrhotic EGVB patients(P<0.05).ROC curve analysis showed that AIMS65 combined with NLR was more effective than AIMS65 alone and NLR in predicting in-hospital death in cirrhotic EGVB patients,with the highest predictive efficacy,and the difference was statistically significant(P<0.05).Conclusion AIMS65 score combined with NLR can predict the risk of in-hospital mortality in cirrhotic EGVB patients,providing ideas for risk stratification as well as individualized intervention in such patients.