Analysis of the Dose-Response Relationship Between the International Normalized Ratio and Hepatic Encephalopathy in Patients With Liver Cirrhosis Using Restricted Cubic Spline Functions

作者全名："Tan, Juntao; He, Yuxin; Li, Zhanbiao; Zhang, Qinghua; Yang, Yanzhi; Xu, Qian; Xu, Xiaomei"

作者地址："[Tan, Juntao; Li, Zhanbiao] Chongqing Med Univ, Operat Management Off, Affiliated Banan Hosp, Chongqing, Peoples R China; [He, Yuxin] Chongqing Med Univ, Dept Med Adm, Affiliated Banan Hosp, Chongqing, Peoples R China; [Zhang, Qinghua] Chongqing Med Univ, Dept Sci & Educ, Affiliated Banan Hosp, Chongqing, Peoples R China; [Yang, Yanzhi] Chengdu First Peoples Hosp, Dept Endocrinol & Metab, Chengdu, Peoples R China; [Xu, Qian] Chongqing Med Univ, Coll Med Informat, Chongqing, Peoples R China; [Xu, Qian] Chongqing Med Univ, Med Data Sci Acad, Chongqing, Peoples R China; [Xu, Qian] Chongqing Med Univ, Lib, Chongqing, Peoples R China; [Xu, Xiaomei] Fifth Peoples Hosp Chengdu, Dept Infect Dis, Chengdu, Peoples R China; [Xu, Xiaomei] Chongqing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Xu, XM (通讯作者)，Fifth Peoples Hosp Chengdu, Dept Infect Dis, Chengdu, Peoples R China.; Xu, XM (通讯作者)，Chongqing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Chongqing, Peoples R China."

来源：FRONTIERS IN PUBLIC HEALTH

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:000823678600001

JCR分区：Q1

影响因子：5.2

年份：2022

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：international normalized ratio; liver cirrhosis; hepatic encephalopathy; restricted cubic spline; dose-response

摘要："BackgroundThe International Normalized Ratio (INR) is significantly associated with Hepatic Encephalopathy (HE) in patients with liver cirrhosis. However, the dose-response relationship between continuous INR changes and HE risk has not been clearly defined. Thus, our goal was to explore the continuous relationship between HE and INR among patients hospitalized with liver cirrhosis and to evaluate the role of the INR as a risk factor for HE in these patients. MethodsA total of 6,266 people were extracted from the Big Data Platform of the Medical Data Research Institute of Chongqing Medical University. In this study, unconditional logistic regression and restricted cubic spline (RCS) model were used to analyze the dose-response association of INR with HE. Alcoholic liver disease, smoking status, and drinking status were classified for subgroup analysis. ResultsThe prevalence of HE in the study population was 8.36%. The median INR was 1.4. After adjusting for alcoholic liver disease, age, smoking status, drinking status, total bilirubin, neutrophil percentage, total hemoglobin, aspartate aminotransferase, serum sodium, albumin, lymphocyte percentage, serum creatinine, red blood cell, and white blood cell, multivariate logistic regression analysis revealed that INR >= 1.5 (OR = 2.606, 95% CI: 2.072-3.278) was significantly related to HE risk. The RCS model showed a non-linear relationship between the INR and HE (non-linear test, chi(2) = 30.940, P < 0.001), and an increased INR was an independent and adjusted dose-dependent risk factor for HE among patients with liver cirrhosis. ConclusionThis finding could guide clinicians to develop individualized counseling programs and treatments for patients with HE based on the INR risk stratification."

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