Prognostic value of combined detection of alpha-fetoprotein, plasma prothrombin activity, and serum prealbumin in acute-on-chronic liver failure

Table 1 Inter-group comparison of basic data, n (%)

Groups	Survival group (n = 47)	Death group (n = 40)	Statistical values	P value
Sex			4.315	0.092
Male	35 (74.47)	31 (77.50)
Female	12 (25.53)	9 (22.50)
Age (years old)	49.31 ± 10.29	50.32 ± 11.23	5.327	0.153
Body mass index (kg/m2)	22.94 ± 2.34	22.97 ± 2.50	4.142	0.325
Disease course (years)	9.21 ± 3.20	9.25 ± 3.32	5.424	0.619
Type of primary disease			4.527	0.153
Viral hepatitis	32 (68.09)	28 (70.00)
Alcoholic hepatitis	10 (21.28)	8 (20.00)
Drug-induced hepatitis	4 (8.51)	3 (7.50)
Others	1 (2.13)	1 (2.50)

Table 2 Inter-group comparison of alpha-fetoprotein, prothrombin activity, and prealbumin levels among acute-on-chronic liver failure patients with different survival outcomes, mean ± SD

Groups	Survival group (n = 47)	Death group (n = 40)	Statistical values	P value
AFP (ng/mL)	120.99 ± 11.81	77.65 ± 25.14	10.539	< 0.001
PTA (μg/L)	34.81 ± 8.11	25.84 ± 4.56	6.207	< 0.001
PA (mg/L)	85.08 ± 24.30	50.27 ± 22.18	6.930	< 0.001

AFP: Alpha-fetoprotein; PTA: Prothrombin activity; PA: Prealbumin.

Table 3 Correlations of alpha-fetoprotein, prothrombin activity, and prealbumin with different survival outcomes

Groups	Survival outcomes (survival)
	r	P value
AFP (ng/mL)	0.753	< 0.001
PTA (μg/L)	0.559	< 0.001
PA (mg/L)	0.601	< 0.001

AFP: Alpha-fetoprotein; PTA: Prothrombin activity; PA: Prealbumin.

Table 4 Diagnostic value of alpha-fetoprotein + prothrombin activity + prealbumin detection for prognosis of acute-on-chronic liver failure patients

Indicators	Sensitivity (%)	Specificity (%)	Youden index	Cut-off	AUC	95%CI
AFP (ng/mL)	80.00	100.00	0.800	99.080	0.907	0.839-0.976
PTA (μg/L)	74.50	87.50	0.620	30.795	0.849	0.766-0.931
PA (mg/L)	70.20	95.50	0.652	78.235	0.853	0.773-0.933
Joint detection	95.70	95.50	0.907	-	0.989	0.974-1.000

AFP: Alpha-fetoprotein; PTA: Prothrombin activity; PA: Prealbumin; AUC: Area under the curve; CI: Confidence interval.