Libo Yan, Man Yuan, Mao Su, Kunping Cui, Xiangnan Teng, Fang Yuan, Lang Bai
{"title":"ct测量肝脾体积比与HBV-ACLF患者死亡率的u型关系","authors":"Libo Yan, Man Yuan, Mao Su, Kunping Cui, Xiangnan Teng, Fang Yuan, Lang Bai","doi":"10.1111/jvh.70076","DOIUrl":null,"url":null,"abstract":"<p>Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition with high short-term mortality, making early prognosis crucial. The liver-to-spleen volume ratio (LSVR) provides important prognostic information but is not included in current tools. This study evaluated the link between LSVR from computed tomography and short-term mortality in HBV-ACLF patients. The study included 278 patients, divided into five groups based on LSVR quintiles. The main outcome was 28-day mortality, with a secondary focus on 90-day mortality. Multivariable Cox regression and restricted cubic splines were used to analyse the LSVR-mortality relationship. Participants had a mean age of 48 years, 82.7% were male, with 28- and 90-day mortality rates of 23.4% and 31.3%, respectively. After adjusting for covariates, the risk of 28-day mortality was elevated by 553% (OR 6.53, 95% CI 1.86–23) in the highest quintile of LSVR (Q5 ≥ 3.6) and by 343% (OR 4.43, 95% CI 1.14–17.16) in the lowest quintile (Q1 ≤ 1.6), as compared to the reference quintile (Q3 2.4–2.9). The curve-fitting results showed a U-shaped relationship between LSVR and the risk of 28-day mortality and 90-day mortality, with an infection point of 2.7. There is a U-shaped relationship between LSVR and mortality in HBV-ACLF patients. Higher or lower LSVR is associated with an increased risk of short-term mortality in HBV-ACLF patients.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 10","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439450/pdf/","citationCount":"0","resultStr":"{\"title\":\"U-Shaped Relationship Between CT-Measured Liver-To-Spleen Volume Ratio and Mortality in HBV-ACLF Patients\",\"authors\":\"Libo Yan, Man Yuan, Mao Su, Kunping Cui, Xiangnan Teng, Fang Yuan, Lang Bai\",\"doi\":\"10.1111/jvh.70076\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition with high short-term mortality, making early prognosis crucial. The liver-to-spleen volume ratio (LSVR) provides important prognostic information but is not included in current tools. This study evaluated the link between LSVR from computed tomography and short-term mortality in HBV-ACLF patients. The study included 278 patients, divided into five groups based on LSVR quintiles. The main outcome was 28-day mortality, with a secondary focus on 90-day mortality. Multivariable Cox regression and restricted cubic splines were used to analyse the LSVR-mortality relationship. Participants had a mean age of 48 years, 82.7% were male, with 28- and 90-day mortality rates of 23.4% and 31.3%, respectively. After adjusting for covariates, the risk of 28-day mortality was elevated by 553% (OR 6.53, 95% CI 1.86–23) in the highest quintile of LSVR (Q5 ≥ 3.6) and by 343% (OR 4.43, 95% CI 1.14–17.16) in the lowest quintile (Q1 ≤ 1.6), as compared to the reference quintile (Q3 2.4–2.9). The curve-fitting results showed a U-shaped relationship between LSVR and the risk of 28-day mortality and 90-day mortality, with an infection point of 2.7. There is a U-shaped relationship between LSVR and mortality in HBV-ACLF patients. Higher or lower LSVR is associated with an increased risk of short-term mortality in HBV-ACLF patients.</p>\",\"PeriodicalId\":17762,\"journal\":{\"name\":\"Journal of Viral Hepatitis\",\"volume\":\"32 10\",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439450/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Viral Hepatitis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jvh.70076\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Viral Hepatitis","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jvh.70076","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
乙型肝炎病毒相关的急性慢性肝衰竭(HBV-ACLF)是一种危及生命的疾病,短期死亡率高,因此早期预后至关重要。肝脾体积比(LSVR)提供了重要的预后信息,但目前的工具没有包括在内。本研究评估了计算机断层扫描的LSVR与HBV-ACLF患者短期死亡率之间的联系。该研究包括278名患者,根据LSVR五分位数分为五组。主要结局是28天死亡率,其次是90天死亡率。采用多变量Cox回归和限制三次样条分析lsvr与死亡率的关系。参与者的平均年龄为48岁,82.7%为男性,28天和90天死亡率分别为23.4%和31.3%。调整协变量后,与参考五分位数(Q3 2.4-2.9)相比,LSVR最高五分位数(Q5≥3.6)28天死亡风险增加了553% (OR 6.53, 95% CI 1.86-23),最低五分位数(Q1≤1.6)28天死亡风险增加了343% (OR 4.43, 95% CI 1.14-17.16)。曲线拟合结果显示,LSVR与28天死亡率和90天死亡率风险呈u型关系,感染点为2.7。HBV-ACLF患者LSVR与死亡率呈u型关系。较高或较低的LSVR与HBV-ACLF患者短期死亡风险增加相关。
U-Shaped Relationship Between CT-Measured Liver-To-Spleen Volume Ratio and Mortality in HBV-ACLF Patients
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition with high short-term mortality, making early prognosis crucial. The liver-to-spleen volume ratio (LSVR) provides important prognostic information but is not included in current tools. This study evaluated the link between LSVR from computed tomography and short-term mortality in HBV-ACLF patients. The study included 278 patients, divided into five groups based on LSVR quintiles. The main outcome was 28-day mortality, with a secondary focus on 90-day mortality. Multivariable Cox regression and restricted cubic splines were used to analyse the LSVR-mortality relationship. Participants had a mean age of 48 years, 82.7% were male, with 28- and 90-day mortality rates of 23.4% and 31.3%, respectively. After adjusting for covariates, the risk of 28-day mortality was elevated by 553% (OR 6.53, 95% CI 1.86–23) in the highest quintile of LSVR (Q5 ≥ 3.6) and by 343% (OR 4.43, 95% CI 1.14–17.16) in the lowest quintile (Q1 ≤ 1.6), as compared to the reference quintile (Q3 2.4–2.9). The curve-fitting results showed a U-shaped relationship between LSVR and the risk of 28-day mortality and 90-day mortality, with an infection point of 2.7. There is a U-shaped relationship between LSVR and mortality in HBV-ACLF patients. Higher or lower LSVR is associated with an increased risk of short-term mortality in HBV-ACLF patients.
期刊介绍:
The Journal of Viral Hepatitis publishes reviews, original work (full papers) and short, rapid communications in the area of viral hepatitis. It solicits these articles from epidemiologists, clinicians, pathologists, virologists and specialists in transfusion medicine working in the field, thereby bringing together in a single journal the important issues in this expanding speciality.
The Journal of Viral Hepatitis is a monthly journal, publishing reviews, original work (full papers) and short rapid communications in the area of viral hepatitis. It brings together in a single journal important issues in this rapidly expanding speciality including articles from:
virologists;
epidemiologists;
clinicians;
pathologists;
specialists in transfusion medicine.