AP&T: 终末期肝病模型(MELD)仍然是肝硬化和重度腹水患者死亡率的更佳预测指标

2020-07-20 MedSci原创 MedSci原创

终末期肝病模型(MELD)评分较高可能预示重度腹水患者预后不良,死亡率也很高。本项研究旨在要开发一种在预测肝硬化,严重腹水和MELD≤18的患者的一年死亡率方面优于MELD评分的模型。

背景

终末期肝病模型(MELD)评分较高可能预示重度腹水患者预后不良,死亡率也很高。本项研究旨在要开发一种在预测肝硬化,严重腹水和MELD≤18的患者的一年死亡率方面优于MELD评分的模型。

 

方法

研究人员使用了来自肝硬化和重度腹水患者的随机试验的数据,开发了预测1年死亡率的模型。研究人员使用逐步向后消除和Cox回归来确定最强的预测因子。使用C指数和Brier得分评估绩效。

 

结果

本项研究共纳入了308例1年死亡率为20.4%的患者。最终预测模型(严重腹水死亡率评分,“ SAM评分”)包括四个变量:血清胆红素,血清钠,SBP病史和糖尿病(是或否)。结果显示SAM和MELD评分的预测能力几乎相同。外部验证队列包括149例患者,其1年死亡率为22.4%。在该队列中,MELD评分表现稍好,部分原因是该队列中SBP和糖尿病对死亡率的影响小得多。

 

结论

在肝硬化和严重腹水患者中,MELD评分仍然是最好的预测模型。

 

原始出处:

Peter Jepsen. Et al. MELD remains the best predictor of mortality in outpatients with cirrhosis and severe ascites. Alimentary Pharmacology and Therapeutics.2020.

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    2020-07-21 jianjun72
  7. [GetPortalCommentsPageByObjectIdResponse(id=1693505, encodeId=9ba7169350545, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Fri Nov 20 00:47:15 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983675, encodeId=8e1819836e500, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jan 13 22:47:15 CST 2021, time=2021-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724402, encodeId=19b81e24402a6, content=<a href='/topic/show?id=8dd8e8164c1' target=_blank style='color:#2F92EE;'>#终末期肝病模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78164, encryptionId=8dd8e8164c1, topicName=终末期肝病模型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a42233641470, createdName=hxq78327, createdTime=Sun Dec 27 14:47:15 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808069, encodeId=07d01808069f0, content=<a href='/topic/show?id=214681260c7' target=_blank style='color:#2F92EE;'>#肝病模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81260, encryptionId=214681260c7, topicName=肝病模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cbcc223, createdName=cooco, createdTime=Sun Aug 23 10:47:15 CST 2020, time=2020-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407044, encodeId=f262140e044b3, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Tue Jul 21 23:47:15 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585441, encodeId=98061585441eb, content=<a href='/topic/show?id=5207115301f' target=_blank style='color:#2F92EE;'>#MELD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11530, encryptionId=5207115301f, topicName=MELD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=880e17187104, createdName=jianjun72, createdTime=Tue Jul 21 23:47:15 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046449, encodeId=86df104644986, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Jul 20 11:47:15 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047831, encodeId=0fea104e83116, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Jul 20 11:47:15 CST 2020, time=2020-07-20, status=1, ipAttribution=)]
    2020-07-20 guging

    谢谢!最新的信息读起来就是收获大

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1693505, encodeId=9ba7169350545, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Fri Nov 20 00:47:15 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983675, encodeId=8e1819836e500, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jan 13 22:47:15 CST 2021, time=2021-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724402, encodeId=19b81e24402a6, content=<a href='/topic/show?id=8dd8e8164c1' target=_blank style='color:#2F92EE;'>#终末期肝病模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78164, encryptionId=8dd8e8164c1, topicName=终末期肝病模型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a42233641470, createdName=hxq78327, createdTime=Sun Dec 27 14:47:15 CST 2020, time=2020-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808069, encodeId=07d01808069f0, content=<a href='/topic/show?id=214681260c7' target=_blank style='color:#2F92EE;'>#肝病模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81260, encryptionId=214681260c7, topicName=肝病模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cbcc223, createdName=cooco, createdTime=Sun Aug 23 10:47:15 CST 2020, time=2020-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407044, encodeId=f262140e044b3, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Tue Jul 21 23:47:15 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585441, encodeId=98061585441eb, content=<a href='/topic/show?id=5207115301f' target=_blank style='color:#2F92EE;'>#MELD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11530, encryptionId=5207115301f, topicName=MELD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=880e17187104, createdName=jianjun72, createdTime=Tue Jul 21 23:47:15 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046449, encodeId=86df104644986, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Jul 20 11:47:15 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047831, encodeId=0fea104e83116, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Jul 20 11:47:15 CST 2020, time=2020-07-20, status=1, ipAttribution=)]
    2020-07-20 CHANGE

    梅斯里提供了很多疾病的模型计算公式,赞一个!

    0

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