ObjectiveThis paper aims to explore the predictive value of serum catechinostatin (CST), lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), and cholinesterase (ChE) levels for postoperative survival in patients with decompensated cirrhosis undergoing splenectomy.MethodsA total of 115 patients with decompensated liver cirrhosis who underwent splenectomy at Nanchong Central Hospital from April 2016 to January 2021 were selected as the study subjects. Patients were followed up for 2 years after surgery and categorized into a survival group and a death group based on their survival status. ELISA was used to detect and compare the serum levels of CST, LOX-1, and ChE between the two groups. Clinical data were also analyzed. Multivariate Cox regression analysis was performed to explore factors affecting survival. ROC curve analysis was used to analyze the predictive value of serum CST, LOX-1, and ChE for postoperative survival.ResultsStatistically significant differences are observed between the survival and death groups in terms of gender, portal vein diameter, splenic vein diameter, presence of portal vein thrombosis, platelet count (PLT), and D-dimer levels (P<0.05). Compared with the survival group, the death group shows significantly higher serum CST and LOX-1 levels and lower serum ChE levels (P<0.05). Multivariate Cox regression analysis shows that gender, portal vein diameter, splenic vein diameter, postoperative portal vein thrombosis, PLT, D-dimer, CST, LOX-1, and ChE are factors affecting survival of patients with decompensated cirrhosis after splenectomy (P<0.05). The area under the ROC curve (AUC) for CST, LOX-1, and ChE in predicting postoperative survival in patients are 0.878, 0.853, 0.882, and 0.964, respectively. The predictive value of the three combined tests is higher than that of any individual prediction (Z_{triple combination-CST}=3.238, Z_{triple combination-LOX-1}=3.601, Z_{triple combination-ChE}=2.945, P<0.05).ConclusionsIn patients with decompensated cirrhosis who died after splenectomy, serum CST and LOX-1 levels are significantly increased, while serum ChE levels are significantly decreased. Serum CST, LOX-1, and ChE have the potential to be used as valuable biomarkers for predicting postoperative survival of decompensated liver cirrhosis patients, with combined detection offering superior predictive performance.