The Value Of EGFR In Prognosis Of Liver Failure

Objective:To explore the application value of MELD improved score based on eGFR in the prognosis of patients with liver failure.Method:A retrospective analysis of the follow-up data of 558 patients with liver failure diagnosed at the First Affiliated Hospital of Xinjiang Medical University from December 2001 to September 2017 was divided into survival groups according to the 3-month survival status(n=238)and death group(n=320).Univariate analysis was performed using eGFR instead of serum creatinine,Cox regression analysis was further performed,and MELD score was fitted by SAS9.0 PHREG.The receiver operating characteristic curve(ROC curve)was drawn and the value of MELD improved score and MELD score in predicting the prognosis of patients with liver failure at3 months was compared.Results:Cox regression analysis showed that total bilirubin,international normalized ratio(INR),and eGFR were independent prognostic factors for patients with liver failure.The fitted MELD modified score=4.07×ln total bilirubin(mg/dL)12.99×ln INR-8.32×ln eGFR.The area under the ROC curve of the MELD improved score and the MELD score were 0.814 and 0.757,respectively,and the sensitivity and specificity of the MELD improved score were 70.0%and 71.4%,respectively.The predictive power of MELD improved scores in patients with liver failure was better than MELD score(Z=4.47,P<0.01).Kaplan-Meier method was used to analyze the survival rate of patients with liver failure.The 3-month survival rate of patients with MELD improved score...