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[Predicting mortality for 205 cirrhotic patients by APARCHEIII score system]
1Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
Objective:
To evaluate the prognostic value of APARCHEIII (acute physiology, age and chronic health evaluation) score system for cirrhosis patients.
Methods:
The clinic data of 205 cirrhotic patients were prospectively collected, APARCHEIII and Child-Pugh scores for each patient were recorded on admission day. Using discrimination analysis, the predictive accuracy of the two systems was investigated.
Results:
The complication included GI bleeding (15.6%), encephalopathy (10.6%), hepatorenal syndrome (8.8%), primary liver carcinoma (8.8%), and spontaneous bacterial peritonitis (4.8%). Fifty patients (24%) died. The major cause of death was GI bleeding (40%), hepatorenal syndrome (34%), hepatic failure (20%) and spontaneous bacterial peritonitis (6%). APARCHEIII and Child score for survivors was 19.3+/-8.6 and 7.4+/-1.8, significantly lower than those for nonsurvivors (47.9+/-20.1 and 10.6+/-2.4). APARCHEIII score system correctly predicted 82.3% of death cases vs 72.7% for Child system. When combined with the information of ascites and prothrombin prolongation time, 88.2% cases could be correctly identified in advance.
Conclusion:
The APARCHEIII score system is a more efficient and accurate predictive system than Child for prognosticating short-term survival of cirrhotic patients and worth use in clinic.