Objective:To discuss the early predict value of sequential organ failure assessment(SOFA)score of 28-days mortality in liver transplantation patients.Methods:Totally 64 patients who received liver transplantation in Department of Hepatic Surgery in Zhongshan Hospital affiliated to Fudan University were enrolled during January 2015 to September 2016.Patients general information, laboratory results on admission and postoperative days (POD) 1-7 (POD1-7) and, operation indexes and 28-days mortality were analyzed.Results:The cut-off point of SOFA score of POD1-7 was 5.5, sensitivity and specificity of SOFA score predicting 28-days mortality was 100% and 94.8%;28-days mortality of patients with SOFA score >5 was 33.3% (6/18);moreover, the levels of platelets, total bilirubin, prothrombin time, creatinine and N-terminal B-type natriuretic peptide(NT-proBNP)in patients with SOFA score >5 (n=18) were of statistically significance compared to that of patients with SOFA score≤5 (n=46), P<0.05.Conclusions:SOFA score, which combined with the levels of platelets, bilirubin, prothrombin time, NT-proBNP and creatinine can early and effectively predict 28-days mortality in liver transplantation patients.%目的:探讨序贯器官衰竭评分(sequential organ failure assessment, SOFA)对肝移植患者术后28 d死亡率的早期预测价值.方法:收集2015年1月至2016年9月64例在复旦大学附属中山医院肝外科接受同种异体肝移植手术患者的临床资料,包括一般资料、入院时和肝移植术后(postoperative days, POD)1~7 d(POD1-7)的生化检查结果、手术相关指标及术后28 d(POD28)死亡率等,对相关数据进行统计分析.结果:ROC曲线分析提示,POD1-7的SOFA评分预测患者POD28死亡率的临界值是5.5分,其敏感性为100%,特异性为94.8%;POD1-7的SOFA评分>5分的患者POD28死亡率为33.3%(6/18);外周血中的血小板、总胆红素、凝血酶原时间、肌酐及B型氨基端脑钠肽前体(N-terminal B-type natriuretic peptide, NT-proBNP)等生化指标在SOFA评分>5分患者(n=18)与SOFA≤5分患者(n=46)间差异有统计学意义(P<0.05).结论:SOFA评分结合血小板、胆红素、凝血酶原时间、NT-proBNP及肌酐等指标能早期有效预测肝移植患者术后28 d死亡率.
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