Analysis Of Prognostic Factors And Establishment Of Prognostic Index For The Patients With Decompensated Cirhosis

Objective: To analyze prognostic factors and to establish a prognostic index for the patients with decompensated cirhosisMethods: The data about Clinic indexes were collected from 196 patients with decompensated cirrhosis from January 2004 to December 2006 in our hospital. Prognostic factors of decompensated cirrhosis were selected by Cox's proportional hazard regression model and prognostic index(PI) was established. The correlation of PI,CTP and MELD was analyzed by spearman rank correlation, and the accuracy of the correlation at predicting the prognosis of decompensated cirrhosis was evaluated by ROC curve.Results:1.Six prognostic factors were extracted by Cox's proportional hazard regression model: ascites levels,grading of hepatic encephalpathy,upper gastrointestinal bleeding,A/G,INR and serum creatinine.2.PI showed significant correlation with CTP (r=0.716, P<0.001); and also with MELD (r=0.600, P<0.001 ). MELD also showed significant correlation with CTP (r=0.669, P<0.001 )3.The area under ROC curve of PI,CTP and MELD was 0.866,0.780,0.756 respectively in predicting for 3 month duration prognosis of decompensated cirrhosis. The areas was 0.861,0.800,0.791 for 6 month duration and was 0.840,0.745,0.780 for 1 year duration. There were no statistics difference among the accuracy of PI,CTP and MELD in predicting the prognosis of the patients with decompensated cirrhosis (P>0.05)..Conclusions:1. Six risk factors about the prognosis of decompensated cirrhosis are ascites levels,grading of hepatic encephalpathy,upper gastrointestinal bleeding,A/G,INR and serum creatinine.2. The ability of prognosis by PI is superior to CTP and MELD in short and medium term for the decompensated cirrhosis.3.PI is a good evaluation system of the prognosis of decompensated cirrhosis, and it can be used to guide clinicians in selecting treatment methods for the patients with decompensated cirrhosis.