Prognostic value of the prognostic nutritional index in evaluating outcomes of artificial liver support system treatment for hepatitis B virus-related acute-on-chronic liver failure
NIU Hong
YAO Jia
CUI Shaobo
ZHAO Zhizhong
LIN Hong
Abstract：Objective To explore the prognostic value of prognostic nutritional index(PNI)in evaluating outcomes of patients with hepatitis B virus related acute-on-chronic liver failure(HBV-ACLF)treated with artificial liver support system.Methods A total of 123 patients with HBV-ACLF who received artificial liver treatment in Jincheng Major Hospital from January 2022 to December 2023 were enrolled.After 3-month follow-up,they were divided into the good prognosis group and the poor prognosis group according to their outcomes.Baseline data of the two groups of patients,changes in the levels of laboratory-related indicators(at baseline,3rd,7th,14th day after admission),as well as PNI,PNI1(PNI at 7th day after admission minus baseline PNI),and PNI2(PNI at 14th day after admission minus baseline PNI)were compared.Multivariate Logistic regression analysis was used to identify independent risk factors for poor prognosis of HBV-ACLF patients treated with artificial liver support treatment;The Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of PNI(baseline value and dynamic change value)alone and in combination with other indicators for the prognosis of patients with HBV-ACLF treated with artificial liver.Results Compared with the poor prognosis group,patients in the good prognosis group had lower white blood cell counts,neutrophil counts,Child-Turcotte-Pugh(CTP)scores,total bilirubin,interleukin-6(IL-6)levels,and the number of artificial liver treatments;and higher albumin,baseline PNI,hemoglobin(Hb),PNI at 7th day after admission,lymphocyte count,PNI at 14th day after admission,prothrombin activity level,PNI2,and serum sodium(all P＜0.05).Multivariate Logistic regression analysis showed that the factors affecting the poor prognosis of HBV-ACLF patients treated with artificial liver included PNI2,serum sodium,Hb,lymphocyte count,albumin,prothrombin activity,neutrophil count,total bilirubin,IL-6,leukocyte count,the number of artificial liver treatments,CTP scores,and the baseline PNI.ROC curve analysis showed that the accuracy and sensitivity of PNI2 was higher than that of baseline PNI and other single indicators,and the sensitivity and accuracy of the combined test of total bilirubin,Hb,prothrombin activity,neutrophil count,white blood cell count,albumin,lymphocyte count,serum sodium,CTP score,IL-6,baseline PNI,PNI2,and the number of artificial liver treatments was higher than that of any single indicator.Conclusion PNI is an effective indicator for evaluating the prognosis of patients with HBV-ACLF treated with artificial liver,and the combined detection of total bilirubin,Hb,prothrombin activity,neutrophil count,white blood cell count,albumin,lymphocyte count,serum sodium,CTP score,IL-6,baseline PNI,PNI2 and the number of artificial liver treatments has higher predictive value.
Keywords：artificial liverhepatitis Bacute-on-chronic liver failureserum sodium
Publication Date：2025-08-30
Online Publishing Date：2025-08-28(First online date of this platform, not the publication date of the document)
Pages：6( 320-325 )