OASIS评分联合血小板-白蛋白-胆红素指数与急性上消化道出血病情的相关性及对预后评估价值

doi:10.3969/j.issn.1006-6233.2024.03.016

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Abstract Objective: To investigate the correlation of oxford acute severity of illness score (OASIS) combined with platelet-albumin-bilirubin index (PALBI) with the severity of acute upper gastrointestinal bleeding (AUGB) and its evaluated value on prognosis.Methods: The data of 165 patients with AUGB in our hospital were retrospectively analyzed, and the patients were divided into high-risk group (n=44), medium-risk group(n=63) and low-risk group(n=58) according to the risk classification of Expert Consensus 2020 on the Emergency Diagnosis and Treatment of Acute Upper Gastrointestinal Bleeding. OASIS score and PALBI index were compared among the three groups. Spearman correlation analysis was used to analyze the relationship between OASIS score and PALBI index and risk degree of AUGB. All patients underwent clinical treatment, and then they were divided into good prognosis group (n=114) and poor prognosis group (n=51) according to whether rebleeding, intensive care and death occurred after treatment. The general clinical data and laboratory indicators were compared between the two groups, Logistic regression model was applied to analyze the related factors affecting the prognosis of patients with AUGB, and receiver operating characteristics (ROC) curve was used to analyze the value of OASIS score and PALBI index on the prognosis of patients with AUGB. Results: OASIS score and PALBI index in high-risk group were significantly higher than those in middle-risk group and low-risk group (P<0.05), and OASIS score and PALBI index in middle-risk group were significantly higher than those in low-risk group (P<0.05). Spearman correlation analysis analysis showed that OASIS score and PALBI index were significantly positively correlated with AUGB risk degree (P<0.05). AUGB frequency, proportions of hematemesis and Helicobacter pylori infection, heart rate, respiratory rate, OASIS score and PALBI index in poor prognosis group were significantly higher than those in good prognosis group (P<0.05) while HBG, ALB and PLT were significantly lower than those in good prognosis group (P<0.05). There were no statistically significant differences in gender, age, BMI, past history, proportions of syncope, melena and heart failure, etiology, serum TBIL, ALT, AST, Ser, UA, BUN, PT, TT and APTT between the two groups (P>0.05). Multivariate Logistic regression analysis showed that AUGB frequency, hematemesis, OASIS score and PALBI index were the risk factors affecting the prognosis of patients with AUGB (P<0.05). ROC curve analysis showed that the sensitivities of OASIS score and PALBI index alone and in combination in predicting prognosis of patients with AUGB were 88.24%, 70.59% and 90.20%, and the specificities were 80.70%, 78.95% and 84.21%, and the AUCs were 0.897, 0.806 and 0.929 respectively. Combined diagnosis had higher predictive value. Conclusion: OASIS score and PALBI index are significantly correlated with disease condition of patients with AUGB, and have high predictive value on prognosis of patients.

Key words： Acute upper gastrointestinal bleeding Oxford acute severity of illness score Platelet-albumin-bilirubin index Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.03.016 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I3/441

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