Study On The Liver To Abdominal Area Ratio In Predicting The Prognosis Of Patients With Decompensated Cirrhosis

Objective:The liver to abdominal area ratio（LAAR）is a new model for evaluating the prognosis of patients with decompensated liver cirrhosis,which was proposed by foreign scholars in recent years but rarely reported in C hina.This study aimed to verify whether LAAR is suitable for the prediction of short and medium term prognosis in cirrhosis.Methods:A total of 85 patients with cirrhosis who had complete hospitalization data and follow-up results were retrospectively selected,and survival data for 3 months and 1years were recorded.LAAR was calculated on a computed tomography slice where the greatest liver area was observed,using the formula[LAAR=（liver area/abdominal area）×100].Cox proportional hazards model was used to explore the factors influencing the prognosis of patients.Survival rates of patients with different LAAR values were compared using Kaplan-Meier survival analysis.The prognostic accuracy of the LAAR score was determined by area under the receiver operated characteristic curve（AUC）,and Comparison among LAAR,Child-Turcotte-Pugh（CTP）and Model for End-Stage Liver Disease（MELD）was made.Normal distributed data were compared by independent sample T test,while Non Normal distributed data compared by the Mann-Whiteny U test.Categorical variables were assessed using the?² test.Results:According to the COX analysis,LAAR was one of independent risk factors for both short and medium term prognosis of patients（3 months at follow-up:OR=0.944P<0.05;1 year at follow-up:OR=0.939 P<0.05）.The LAAR value of the patients who died was significantly lower than that of the survival group（3 months at follow-up:t=-3.287,1years at follow-up:t=-4.153,both P<0.05）.ROC curve analysis showed that the optimal cut-off of LAAR was 33.8 and patients were divided into high-risk group and low-risk group by the optimal cut-off.Kaplan-Meier survival curves of 3 months and 1 year at follow-up were plotted respectively and showed that the survival rate of patients with a LAAR score below 33.8 was much lower than those with a LAAR score above 33.8（3months at follow-up:?²=14.318,1 years at follow-up:?²=17.516,both P<0.05）.The area under the ROC curve of LAAR,CTP and MELD at 3 months were 0.719（95%CI:0.582?0.855）,0.776（95%CI:0.671?0.880）and 0.793（95%CI:0.681?0.906）.The area under the ROC curve of LAAR,C TP and MELD at 1 year were 0.744（95%CI:0.635?0.853）,0.749（95%CI:0.644?0.855）and 0.762（95%CI:0.650?0.873）.The area under the ROC curve of these three prognostic models at both 3 months and 1 year was both greater than 0.7 and the difference was not statistically significant（P>0.05）,which meant that they were all effective in assessing the prognosis of patients with cirrhosis.Conclusions:LAAR has a certain value in predicting short and medium term prognosis of patients with decompensated cirrhosis in C hina,and combining LAAR with MELD and CTP score can improve the accuracy of prognosis evaluation.