{"title":"三种评分系统与肝硬化合并脓毒症患者预后的相关性。","authors":"Li-Nan Liu, Yu-Fei Chang, Hui Wang","doi":"10.4240/wjgs.v17.i3.99570","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Severe symptoms associated with sepsis syndrome (SS) are considered a severe threat, which not only increases therapeutic difficulty but also causes a prognostic mortality rate. However, at present, few related studies focused on the application of different score scales for disease and prognosis assessment in liver cirrhosis (LC) complicated with SS.</p><p><strong>Aim: </strong>To determine the correlations of the model for end-stage liver disease (MELD), sequential organ failure assessment (SOFA), and modified early warning score (MEWS) points with the prognosis of patients with LC complicated with SS.</p><p><strong>Methods: </strong>This retrospective analysis included 426 LC cases from February 2019 to April 2022. Of them, 225 cases that were complicated with SS were assigned to the LC + SS group, and 201 simple LC cases were included in the LC group. Intergroup differences in MELD, SOFA, and MEWS scores were compared, as well as their diagnostic value for LC + SS. The correlations of the three scores with the prognosis of patients with LC + SS were further analyzed, as well as the related risk factors affecting patients' outcomes, after the follow-up investigation.</p><p><strong>Results: </strong>MELD, SOFA, and MEWS scores were all higher in the LC + SS group <i>vs</i> the LC group, and their combined assessment for LC + SS revealed a diagnostic sensitivity and a specificity of 89.66% and 90.84%, respectively (<i>P</i> < 0.05). The LC + SS group reported 58 deaths, with an overall mortality rate of 25.78%. Deceased patients presented higher MELD, SOFA, and MEWS points than those who survived (<i>P</i> < 0.05). MELD, SOFA, and MEWS scores were determined by COX analysis as factors independently affecting the prognosis of patients with LC + SS (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>MELD, SOFA, and MEWS effectively diagnosed LC in patients complicated with SS, and they demonstrated great significance in assessing prognosis, which provides a reliable prognosis guarantee for patients with LC + SS. However, their assessment effects remain limited, which is worthy of further investigation by more in-depth and rigorous experimental analysis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99570"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948096/pdf/","citationCount":"0","resultStr":"{\"title\":\"Correlations of three scoring systems with the prognosis of patients with liver cirrhosis complicated with sepsis syndrome.\",\"authors\":\"Li-Nan Liu, Yu-Fei Chang, Hui Wang\",\"doi\":\"10.4240/wjgs.v17.i3.99570\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Severe symptoms associated with sepsis syndrome (SS) are considered a severe threat, which not only increases therapeutic difficulty but also causes a prognostic mortality rate. However, at present, few related studies focused on the application of different score scales for disease and prognosis assessment in liver cirrhosis (LC) complicated with SS.</p><p><strong>Aim: </strong>To determine the correlations of the model for end-stage liver disease (MELD), sequential organ failure assessment (SOFA), and modified early warning score (MEWS) points with the prognosis of patients with LC complicated with SS.</p><p><strong>Methods: </strong>This retrospective analysis included 426 LC cases from February 2019 to April 2022. Of them, 225 cases that were complicated with SS were assigned to the LC + SS group, and 201 simple LC cases were included in the LC group. Intergroup differences in MELD, SOFA, and MEWS scores were compared, as well as their diagnostic value for LC + SS. The correlations of the three scores with the prognosis of patients with LC + SS were further analyzed, as well as the related risk factors affecting patients' outcomes, after the follow-up investigation.</p><p><strong>Results: </strong>MELD, SOFA, and MEWS scores were all higher in the LC + SS group <i>vs</i> the LC group, and their combined assessment for LC + SS revealed a diagnostic sensitivity and a specificity of 89.66% and 90.84%, respectively (<i>P</i> < 0.05). The LC + SS group reported 58 deaths, with an overall mortality rate of 25.78%. Deceased patients presented higher MELD, SOFA, and MEWS points than those who survived (<i>P</i> < 0.05). MELD, SOFA, and MEWS scores were determined by COX analysis as factors independently affecting the prognosis of patients with LC + SS (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>MELD, SOFA, and MEWS effectively diagnosed LC in patients complicated with SS, and they demonstrated great significance in assessing prognosis, which provides a reliable prognosis guarantee for patients with LC + SS. However, their assessment effects remain limited, which is worthy of further investigation by more in-depth and rigorous experimental analysis.</p>\",\"PeriodicalId\":23759,\"journal\":{\"name\":\"World Journal of Gastrointestinal Surgery\",\"volume\":\"17 3\",\"pages\":\"99570\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-03-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948096/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4240/wjgs.v17.i3.99570\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4240/wjgs.v17.i3.99570","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Correlations of three scoring systems with the prognosis of patients with liver cirrhosis complicated with sepsis syndrome.
Background: Severe symptoms associated with sepsis syndrome (SS) are considered a severe threat, which not only increases therapeutic difficulty but also causes a prognostic mortality rate. However, at present, few related studies focused on the application of different score scales for disease and prognosis assessment in liver cirrhosis (LC) complicated with SS.
Aim: To determine the correlations of the model for end-stage liver disease (MELD), sequential organ failure assessment (SOFA), and modified early warning score (MEWS) points with the prognosis of patients with LC complicated with SS.
Methods: This retrospective analysis included 426 LC cases from February 2019 to April 2022. Of them, 225 cases that were complicated with SS were assigned to the LC + SS group, and 201 simple LC cases were included in the LC group. Intergroup differences in MELD, SOFA, and MEWS scores were compared, as well as their diagnostic value for LC + SS. The correlations of the three scores with the prognosis of patients with LC + SS were further analyzed, as well as the related risk factors affecting patients' outcomes, after the follow-up investigation.
Results: MELD, SOFA, and MEWS scores were all higher in the LC + SS group vs the LC group, and their combined assessment for LC + SS revealed a diagnostic sensitivity and a specificity of 89.66% and 90.84%, respectively (P < 0.05). The LC + SS group reported 58 deaths, with an overall mortality rate of 25.78%. Deceased patients presented higher MELD, SOFA, and MEWS points than those who survived (P < 0.05). MELD, SOFA, and MEWS scores were determined by COX analysis as factors independently affecting the prognosis of patients with LC + SS (P < 0.05).
Conclusion: MELD, SOFA, and MEWS effectively diagnosed LC in patients complicated with SS, and they demonstrated great significance in assessing prognosis, which provides a reliable prognosis guarantee for patients with LC + SS. However, their assessment effects remain limited, which is worthy of further investigation by more in-depth and rigorous experimental analysis.