Nomogram prediction of individual prognosis of patients with acute-on-chronic hepatitis B liver failure |
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| Authors: | Fangyuan Gao Qianqian Zhang Yao Liu Guozhong Gong Dewen Mao Zuojiong Gong Jun Li Xinla Luo Xiaoliang Li Guoliang Chen Yong Li Wenxia Zhao Gang Wan Hai Li Kewei Sun Xianbo Wang |
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| Institution: | 1. Center of Integrative Medicine, Beijing Ditan Hospital Capital Medical University, Beijing, China;2. Department of Hepatology, The First Hospital Affiliated to Hunan University of Chinese Medicine, Changsha, China;3. Department of Infectious Diseases, The Second Xiangya Hospital of Center South University, Changsha, China;4. Department of Hepatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China;5. Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, China;6. Center of Integrative Medicine, 302 Military Hospital of China, Beijing, China;7. Department of Hepatology, Hubei Provincial Hospital of TCM, Wuhuan, China;8. Department of Traditional Chinese Medicine, The Third People Hospital of Shenzhen, Shenzhen, China;9. Department of Hepatology, Xiamen Hospital of TCM, Xiamen, China;10. Department of Hepatology, Shandong Provincial Hospital of TCM, Jinan, China;11. Department of Gastroenterology, The First Affiliated Hospital of Henan University of TCM, Zhengzhou, China;12. Statistics Room, Beijing Ditan Hospital Capital Medical University, Beijing, China;13. Department of Gastroenterology, Renji Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China |
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| Abstract: | BackgroundThe current definitions and etiologies of acute-on-chronic liver failure (ACLF) are clearly very different between East and West.AimsThis study aimed to develop an effective prognostic nomogram for acute-on-chronic hepatitis B liver failure (ACHBLF) as defined by the Asia Pacific Association for the Study of the Liver (APASL).MethodsThe nomogram was based on a retrospective study of 573 patients with ACHBLF, defined according to the APASL, at the Beijing Ditan Hospital. The results were validated using a bootstrapped approach to correct for bias in two external cohorts, including an APASL ACHBLF cohort (10 hospitals, N?=?329) and an EASL-CLIF ACHBLF cohort (Renji Hospital, N?=?300).ResultsMultivariate analysis of the derivation cohort for survival analysis helped identify the independent factors as age, total bilirubin, albumin, international normalized ratio, and hepatic encephalopathy, which were included in the nomogram. The predictive value of nomogram was the strongest compared with CLIF-C ACLF, MELD and MELD-Na and similar to COSSH-ACLF in both the derivation and prospective validation cohorts with APASL ACHBLF, but the CLIF-C ACLF was better in the EASL-CLIF ACHBLF cohort.ConclusionsThe proposed nomogram could accurately estimate individualized risk for the short-term mortality of patients with ACHBLF as defined by APASL. |
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| Keywords: | Acute-on-chronic liver failure Hepatitis B virus Nomogram Prognosis |
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