Journal of vascular and interventional radiology : JVIR · 2025
Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Combined with Model for End-Stage Liver Disease 3.0 as a Prognostic Predictor for Patients with Liver Cirrhosis after Transjugular Intrahepatic Portosystemic Shunt Creation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Suzuki Takeshi, Michimoto Kenkichi, Yamada Kentaro, Farsad Khashayar
Аннотация
PURPOSE: To evaluate the prognostic value of combining neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with Model for End-stage Liver Disease (MELD)-based scores in predicting mortality after transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with cirrhosis.
MATERIALS AND METHODS: Sixty-four consecutive patients with cirrhosis who underwent TIPS creation between September 2005 and December 2023 and had blood fractionation data within 1 week prior were included in this retrospective study. Logistic regression models were constructed using MELD 3.0, MELD, and MELD score incorporating serum sodium (MELD-Na) alone or combined with NLR and PLR. Predictive performance was assessed using receiver operating characteristic curves and area under the curve (AUC). Kaplan-Meier analysis with the log-rank test was used for survival comparisons.
RESULTS: The model combining NLR and PLR with MELD 3.0 showed improved predictive accuracy for 30-day mortality (7 of 64 deaths; AUC, 0.980 [95% CI, 0.937-1.000]) compared with MELD 3.0 alone (AUC, 0.857 [95% CI, 0.722-0.957]; P = .026). Similar improvements were observed for MELD (AUC, 0.985 vs 0.920; P = .037) and MELD-Na (AUC, 0.972 vs 0.851; P = .013) when NLR and PLR were added. For 3-month mortality (10/64, 15.6%), AUCs were 0.858-0.866 and 0.783-0.857 (P > .05). For 1-year mortality (18/64, 28.1%), AUCs were 0.686-0.712 and 0.674-0.732 (P > .05). Kaplan-Meier analysis revealed significantly lower 30-day survival in patients above the optimal cutoff derived from the combined model (log-rank P = .01).
CONCLUSIONS: Adding NLR and PLR to MELD 3.0 may improve 30-day mortality prediction after TIPS creation.
MATERIALS AND METHODS: Sixty-four consecutive patients with cirrhosis who underwent TIPS creation between September 2005 and December 2023 and had blood fractionation data within 1 week prior were included in this retrospective study. Logistic regression models were constructed using MELD 3.0, MELD, and MELD score incorporating serum sodium (MELD-Na) alone or combined with NLR and PLR. Predictive performance was assessed using receiver operating characteristic curves and area under the curve (AUC). Kaplan-Meier analysis with the log-rank test was used for survival comparisons.
RESULTS: The model combining NLR and PLR with MELD 3.0 showed improved predictive accuracy for 30-day mortality (7 of 64 deaths; AUC, 0.980 [95% CI, 0.937-1.000]) compared with MELD 3.0 alone (AUC, 0.857 [95% CI, 0.722-0.957]; P = .026). Similar improvements were observed for MELD (AUC, 0.985 vs 0.920; P = .037) and MELD-Na (AUC, 0.972 vs 0.851; P = .013) when NLR and PLR were added. For 3-month mortality (10/64, 15.6%), AUCs were 0.858-0.866 and 0.783-0.857 (P > .05). For 1-year mortality (18/64, 28.1%), AUCs were 0.686-0.712 and 0.674-0.732 (P > .05). Kaplan-Meier analysis revealed significantly lower 30-day survival in patients above the optimal cutoff derived from the combined model (log-rank P = .01).
CONCLUSIONS: Adding NLR and PLR to MELD 3.0 may improve 30-day mortality prediction after TIPS creation.