PALBI评分联合CAR在肝硬化自发性细菌性腹膜炎预测中的作用OA

Objective:To analyze the clinical value of platelet-albumin-bilirubin(PALBI)score combined with C-reactive protein/albumin ratio(CAR)in the prediction of spontaneous bacterial peritonitis(SBP)in cirrhosis.Methods:This study was a retrospective analysis based on medical records data,and 358 patients with cirrhotic ascites who were hospitalized and treated in the First Affiliated Hospital of Xi' an Jiaotong University from January 2021 to December 2024 were studied.According to whether SBP occurred during hospitalization,the358 cirrhotic patients were divided into92 cases(25.70%)in the SBP group and266 cases(74.30%)in the non-SBP group.Clinical data of cirrhotic patients after hospitalization were extracted,and the correlation between PALBI and CAR and the occurrence of SBP in cirrhotic patients was assessed by logistic regression,and the efficacy of both in predicting SBP was evaluated by using ROC curves.Results:Inter-comparison showed that PALBI score and CAR were elevated in the SBP group compared with the non-SBP group,and the differences were significant(both P<0.05).In addition,the proportion of concomitant upper gastrointestinal bleeding and hepatic encephalopathy,as well as prothrombin time and calcitoninogen were also significantly higher in the SBP group(all P<0.05),which may be a confounding factor affecting the risk of developing SBP.Multifactorial logistic regression analysis corrected for confounders showed that PALBI score(OR=1.692,95%CI:1.210-2.367)and CAR(OR=1.504,95%CI:1.087-2.081)were independent risk factors for the development of SBP during hospitalization in cirrhotic patients.The ROC curve shows that the AUC for predicting the occurrence of SBP in cirrhosis patients using the combined PALBI score and CAR is 0.859(95%CI:0.813-0.906),which is 12.88%higher than the PALBI score alone[AUC:0.761(95%CI:0.701-0.821)]and 20.99%higher than CAR alone[AUC:0.710(95%CI:0.647-0.722)].Conclusion:The combination of the PALBI score and CAR is an independent risk factor for SBP in cirrhotic patients during hospitalization,and the combination of the two has good predictive performance for SBP,which can provide a practical tool for the clinic to screen out the high-risk group of SBP at an early stage,and is especially valuable for the primary healthcare organizations.