Predictive Value of the Prothrombin Time-International Normalized Ratio to Albumin Ratio in the Prognosis of Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure

Abstract

Yunjian Sheng,1,* Yu Zeng,1,* Wenling Luo,1 Xuemei Zhang,1 Hang Wang,2 Jiahuan Jiao3 1Department of Infectious Diseases, the Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China; 2Department of Gastroenterology, Dazhou Hospital of Integrated Traditional and Western Medicine, Dazhou, Sichuan, People’s Republic of China; 3Department of Infectious Diseases, the People’s Hospital of Leshan, Leshan, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yunjian Sheng, Department of Infectious Diseases, the Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan Province, People’s Republic of China, Email [email protected]: Acute-on-chronic liver failure is a common clinical syndrome with high short-term mortality, and early assessment of its mortality risk is crucial, but the search for valid and accurate prognostic biomarkers is a challenging endeavor. The purpose of this study was to investigate the predictive value of the prothrombin time-international normalized ratio to albumin ratio (PTAR) for mortality in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Patients and methods: A total of 354 patients with HBV-ACLF were included in the retrospective study. Patients were divided into survival and non-survival groups based on 90-day follow-up. Cox regression analysis was used to explore the relationship between PTAR and 90-day mortality in patients with HBV-ACLF. The area under the receiver operating characteristic curve was used to evaluate the effectiveness of PTAR in predicting mortality.Results: PTAR was significantly higher in non-survivors than in survivors. The results of multivariate analysis showed that PTAR was a valid independent predictor of mortality in patients with HBV-ACLF. Its predictive ability for mortality was similar to that of the Child-Turcotte-Pugh score, the end-stage liver disease model (MELD) score, and the MELD-sodium score.Conclusion: PTAR may be a simple and effective tool for predicting the prognosis of patients with HBV-ACLF.Keywords: acute-on-chronic liver failure, hepatitis B virus, prothrombin time-international normalized ratio to albumin ratio, prognosis

Keywords

• acute-on-chronic liver failure
• hepatitis b virus
• prothrombin time-international normalized ratio to albumin ratio
• prognosis