BACKGROUND Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis.However,the current prognostic indicators for predicting long-term overall survival...BACKGROUND Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis.However,the current prognostic indicators for predicting long-term overall survival of these patients have several limitations.AIM To assess the potential of preoperative total bilirubin-albumin(B/A)ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.METHODS A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study.Normality test,t-test,Wilcoxon test,χ2 test,or Fisher’s exact test was employed to analyze the intraoperative and postoperative conditions of the patients.Receiver operating characteristic(ROC)curve analysis was utilized to depict the 10-year overall survival rate.RESULTS During the follow-up period,85.99%of the patients survived,with a median survival time of 64.6 months.Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival(P=0.037).ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value.Consequently,the patients were categorized into two groups:High B/A group(n=64)and low B/A group(n=193).The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months,respectively(P=0.045).Notably,the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group(P<0.001).Patients with hepatocellular carcinoma(HCC)had lower overall survival rates.Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not,early Child-Pugh grade,low albumin-bilirubin grade,and model for end-stage liver disease score≥10(log-rank test,P<0.001 for all).CONCLUSION The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virusrelated cirrhosis following splenectomy,and a higher B/A ratio may suggest a poorer prognosis.展开更多
文摘BACKGROUND Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis.However,the current prognostic indicators for predicting long-term overall survival of these patients have several limitations.AIM To assess the potential of preoperative total bilirubin-albumin(B/A)ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.METHODS A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study.Normality test,t-test,Wilcoxon test,χ2 test,or Fisher’s exact test was employed to analyze the intraoperative and postoperative conditions of the patients.Receiver operating characteristic(ROC)curve analysis was utilized to depict the 10-year overall survival rate.RESULTS During the follow-up period,85.99%of the patients survived,with a median survival time of 64.6 months.Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival(P=0.037).ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value.Consequently,the patients were categorized into two groups:High B/A group(n=64)and low B/A group(n=193).The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months,respectively(P=0.045).Notably,the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group(P<0.001).Patients with hepatocellular carcinoma(HCC)had lower overall survival rates.Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not,early Child-Pugh grade,low albumin-bilirubin grade,and model for end-stage liver disease score≥10(log-rank test,P<0.001 for all).CONCLUSION The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virusrelated cirrhosis following splenectomy,and a higher B/A ratio may suggest a poorer prognosis.
