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Dejanović B, Barak O, Čolović P, Janjić N, Savić Ž, Gvozdanović N, Ružić M. Hospital Mortality in Acute Decompensation of Alcoholic Liver Cirrhosis: Can Novel Survival Markers Outperform Traditional Ones? J Clin Med 2024; 13:6208. [PMID: 39458158 PMCID: PMC11508931 DOI: 10.3390/jcm13206208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Revised: 10/13/2024] [Accepted: 10/16/2024] [Indexed: 10/28/2024] Open
Abstract
Background: There is a strong correlation between systemic inflammation intensity and clinical presentation, disease progression, and survival during liver cirrhosis decompensation. This study aimed to evaluate the prognostic performance of blood-based biomarkers as meta-inflammation markers, including NLR, PLR, LMR, INPR, MPR, ALBI, FIB4, and APRI, in predicting hospital mortality in patients with acute decompensation of alcohol-related liver cirrhosis. Methods: Data from 411 patients with their first onset of acute decompensation were analyzed, forming two groups: deceased and survived during hospitalization. Generalized partial least squares regression analysis was applied to explore the effects of surrogate indicators on mortality rates, using mortality rate as the dependent variable. Root Mean Square Error, Akaike's, and Bayesian information criteria determined that four components accounted for most of the variance. Results: Variables with significant negative contributions to the outcome prediction (ranked by standardized regression coefficients) were encephalopathy grade, total bilirubin, Child-Turcotte-Pugh score, MELD, NLR, MPV, FIB4, INR, PLR, and ALT. Coefficient sizes ranged from -0.63 to -0.09, with p-values from 0 to 0.018. Conclusions: NLR, PLR, and FIB4 significantly contribute to hospital mortality prediction in patients with acute decompensation of alcohol-related liver cirrhosis. Conversely, some variables used to predict liver disease severity, including INPR, APRI, LMR, and ALBI score, did not significantly contribute to hospital mortality prediction in this patient population.
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Affiliation(s)
- Božidar Dejanović
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (O.B.); (N.J.); (Ž.S.); (N.G.); (M.R.)
- Clinic of Gastroenterology and Hepatology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Otto Barak
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (O.B.); (N.J.); (Ž.S.); (N.G.); (M.R.)
| | - Petar Čolović
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Nebojša Janjić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (O.B.); (N.J.); (Ž.S.); (N.G.); (M.R.)
- Clinic of Gastroenterology and Hepatology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Željka Savić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (O.B.); (N.J.); (Ž.S.); (N.G.); (M.R.)
- Clinic of Gastroenterology and Hepatology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Nikola Gvozdanović
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (O.B.); (N.J.); (Ž.S.); (N.G.); (M.R.)
- Clinic of Gastroenterology and Hepatology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Maja Ružić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (O.B.); (N.J.); (Ž.S.); (N.G.); (M.R.)
- Clinic of Infectious Disease, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
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