Prognostic Nomogram for Patients with Hepatitis E Virus-related Acute Liver Failure: A Multicenter Study in China
| Autor: | Yanping Xu, Xinyu Sheng, Hongcui Cao, Gongqi Li, Jinrong Zhang, Jiong Yu, Cuifen Shi, Lanjuan Li, Jian Wu, Xinguo Zhao, Xinhui Shi |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Scoring model Hepatology business.industry viruses digestive oral and skin physiology Liver failure virus diseases Nomogram medicine.disease_cause Hepatitis E medicine.disease digestive system diseases Multicenter study Hepatitis E virus Mortality prediction Internal medicine medicine Original Article business Acute liver failure |
| Zdroj: | Journal of Clinical and Translational Hepatology |
| ISSN: | 2310-8819 2225-0719 |
| Popis: | Background and Aims Timely and effective assessment scoring systems for predicting the mortality of patients with hepatitis E virus-related acute liver failure (HEV-ALF) are urgently needed. The present study aimed to establish an effective nomogram for predicting the mortality of HEV-ALF patients. Methods The nomogram was based on a cross-sectional set of 404 HEV-ALF patients who were identified and enrolled from a cohort of 650 patients with liver failure. To compare the performance with that of the model for end-stage liver disease (MELD) scoring and CLIF-Consortium-acute-on-chronic liver failure score (CLIF-C-ACLFs) models, we assessed the predictive accuracy of the nomogram using the concordance index (C-index), and its discriminative ability using time-dependent receiver operating characteristics (td-ROC) analysis, respectively. Results Multivariate logistic regression analysis of the development set carried out to predict mortality revealed that γ-glutamyl transpeptidase, albumin, total bilirubin, urea nitrogen, creatinine, international normalized ratio, and neutrophil-to-lymphocyte ratio were independent factors, all of which were incorporated into the new nomogram to predict the mortality of HEV-ALF patients. The area under the curve of this nomogram for mortality prediction was 0.671 (95% confidence interval: 0.602–0.740), which was higher than that of the MELD and CLIF-C-ACLFs models. Moreover, the td-ROC and decision curves analysis showed that both discriminative ability and threshold probabilities of the nomogram were superior to those of the MELD and CLIF-C-ACLFs models. A similar trend was observed in the validation set. Conclusions The novel nomogram is an accurate and efficient mortality prediction method for HEV-ALF patients. |
| Databáze: | OpenAIRE |
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