Published online Jan 27, 2025. doi: 10.4240/wjgs.v17.i1.96512
Revised: September 6, 2024
Accepted: October 28, 2024
Published online: January 27, 2025
Processing time: 232 Days and 23.4 Hours
Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis. However, the current prognostic in
To assess the potential of preoperative total bilirubin-albumin (B/A) ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.
A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study. Normality test, t-test, Wilcoxon test, χ2 test, or Fisher’s exact test was employed to analyze the intraoperative and postoperative conditions of the patients. Receiver operating characteristic (ROC) curve analysis was utilized to depict the 10-year overall survival rate.
During the follow-up period, 85.99% of the patients survived, with a median survival time of 64.6 months. Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival (P = 0.037). ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value. Consequently, the patients were categorized into two groups: High B/A group (n = 64) and low B/A group (n = 193). The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months, respectively (P = 0.045). Notably, the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group (P < 0.001). Patients with hepatocellular carcinoma (HCC) had lower overall survival rates. Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not, early Child-Pugh grade, low albumin-bilirubin grade, and model for end-stage liver disease score ≥ 10 (log-rank test, P < 0.001 for all).
The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virus-related cirrhosis following splenectomy, and a higher B/A ratio may suggest a poorer prognosis.
Core Tip: High serum total bilirubin-albumin (B/A) ratio shows distinct specificities in hepatitis-related cirrhosis patients. In this study, we investigated the B/A ratio as a predictor of overall survival (OS) of hepatitis-related cirrhosis patients after splenectomy. Based on the cutoff point, patients with a high B/A ratio showed a worse long-term survival in the overall cohort and in the subgroups of patients with hepatpcellular carcinoma (HCC), without HCC, early Child-Pugh stage, low albumin-bilirubin grade, and model for end-stage liver disease score ≥ 10. B/A ratio was the only independent risk factor for OS. Because its convenience and effectiveness, the B/A ratio may be used to predict the prognosis of such patients.