Association between lactate-to-albumin ratio and short-term prognosis of acute-on-chronic liver failure treated with artificial liver support system.

IF 2.3 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

European Journal of Gastroenterology & Hepatology Pub Date : 2025-03-01 Epub Date: 2025-01-29 DOI:10.1097/MEG.0000000000002885

Yuanji Ma, Lingyao Du, Lang Bai, Hong Tang

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引用次数: 0

Abstract

Background: The impact of lactate-to-albumin ratio (LAR) on the outcome of acute-on-chronic liver failure (ACLF) is scant.

Aims: To investigate the relationship between LAR and short-term prognosis in patients with COSSH (Chinese Group on the Study of Severe Hepatitis B) ACLF.

Methods: A retrospective cohort study was conducted in patients with COSSH ACLF treated with an artificial liver support system. Restricted cubic splines, linear regression models, and Cox regression models were used to investigate the relationships of LAR with disease severity and 28-day prognosis.

Results: The 28-day transplant-free and overall survival rates in the 258 eligible patients were 76.4% and 82.2%, respectively. The LAR in 28-day transplant-free survivors was lower than that in transplant or death patients [0.74 (0.58-0.98) vs. 1.03 (0.79-1.35), P < 0.001]. The LAR was positively associated with disease severity, 28-day transplant-free survival [adjusted hazard ratio (HR) (95% confidence interval (CI)) for transplant or death: 2.18 (1.37-3.46), P = 0.001], and overall survival [adjusted HR (95% CI) for death: 2.14 (1.21-3.80), P = 0.009]. Compared with patients with LAR < 1.01, patients with LAR ≥ 1.01 had poor 28-day prognosis [all adjusted HR (95% CI) > 1, P < 0.05]. Lactate was not a potential modifier of the relationship between LAR and short-term prognosis.

Conclusion: LAR was positively associated with disease severity and poor short-term prognosis in patients with COSSH ACLF.

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使用人工肝支持系统治疗急性-慢性肝衰竭患者的乳酸-白蛋白比值与短期预后的关系。

背景：目的：研究中国重症乙型肝炎研究组（COSSH）ACLF患者的乳酸白蛋白比值（LAR）与短期预后的关系：方法：对接受人工肝支持系统治疗的 COSSH ACLF 患者进行回顾性队列研究。采用限制性三次样条、线性回归模型和 Cox 回归模型研究 LAR 与疾病严重程度和 28 天预后的关系：结果：258 名符合条件的患者的 28 天无移植生存率和总生存率分别为 76.4% 和 82.2%。28天无移植生存者的LAR低于移植或死亡患者[0.74 (0.58-0.98) vs. 1.03 (0.79-1.35)，P < 0.001]。LAR与疾病严重程度、28天无移植生存率[移植或死亡的调整后危险比（HR）（95% 置信区间（CI））：2.18（1.37-3.46），P = 0.001]和总生存率[死亡的调整后危险比（HR）（95% CI）：2.14（1.21-3.80），P = 0.009]呈正相关。与 LAR < 1.01 的患者相比，LAR ≥ 1.01 的患者 28 天预后较差[调整后 HR (95% CI) > 1，P < 0.05]。乳酸不是LAR与短期预后关系的潜在调节因素：结论：LAR与COSSH ACLF患者的疾病严重程度和短期预后不良呈正相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Gastroenterology & Hepatology 医学-胃肠肝病学

CiteScore

4.40

自引率

4.80%

发文量

269

审稿时长

1 months

期刊介绍： European Journal of Gastroenterology & Hepatology publishes papers reporting original clinical and scientific research which are of a high standard and which contribute to the advancement of knowledge in the field of gastroenterology and hepatology. The journal publishes three types of manuscript: in-depth reviews (by invitation only), full papers and case reports. Manuscripts submitted to the journal will be accepted on the understanding that the author has not previously submitted the paper to another journal or had the material published elsewhere. Authors are asked to disclose any affiliations, including financial, consultant, or institutional associations, that might lead to bias or a conflict of interest.