A MELD-based nomogram for predicting 3-month mortality of patients with acute-on-chronic hepatitis B liver failure

Chen, Ruicong; Wang, Xiaodong; Dong, Jin-Zhong; Lin, Zhuo; Wu, Jianmin; Cai, Yiqi; Shi, Ke‐Qing

doi:10.1016/j.cca.2017.03.005

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…Five related studies had been carried out to evaluate the prognosis of ACLF patients with nomogram (13,(25)(26)(27)(28). The relatively small number of cases in these studies led to some important risk factors not being included in the models (such as liver cirrhosis, HBV DNA load, etc.).…”

Section: Discussionmentioning

confidence: 99%

“…The relatively small number of cases in these studies led to some important risk factors not being included in the models (such as liver cirrhosis, HBV DNA load, etc.). In addition, four out of five studies only compared the nomograms with conventional models, but not with the current mainstream prognostic scoring systems, such as CLIF-C ACLF score and COSSH ACLF score ( 13 , 25 , 27 , 28 ). The model of this study was based on the large cohort data, which could reduce the bias caused by insufficient sample size.…”

Section: Discussionmentioning

confidence: 99%

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Derivation and Validation of a Nomogram for Predicting 90-Day Survival in Patients With HBV-Related Acute-on-Chronic Liver Failure

et al. 2021

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Background: Conventional prognostic models do not fully reflect the severity of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). This study aimed to establish an effective and convenient nomogram for patients with HBV-related ACLF.Methods: A nomogram was developed based on a retrospective cohort of 1,353 patients treated at the Third Affiliated Hospital of Sun Yat-sen University from January 2010 to June 2016. The predictive accuracy and discriminatory ability of the nomogram were determined by a concordance index (C-index) and calibration curve, and were compared with current scoring systems. The results were validated using an independent retrospective cohort of 669 patients consecutively treated at the same institution from July 2016 to March 2018. This study is registered at ClinicalTrials.gov (NCT03992898).Results: Multivariable analysis of the derivation cohort found that independent predictors of 90-day survival were age, white blood cell (WBC) count, hemoglobin (Hb), aspartate aminotransferase (AST), total bilirubin (TBil), international normalized ratio, serum creatinine (Cr), alpha fetoprotein (AFP), serum sodium (Na), hepatic encephalopathy (HE), pre-existing chronic liver disease(PreLD), and HBV DNA load. All factors were included in the nomogram. The nomogram calibration curve for the probability of 90-day survival indicated that nomogram-based predictions were in good agreement with actual observations. The C-index of the nomogram was 0.790, which was statistically significantly greater than those for the current scoring systems in the derivation cohort (P < 0.001). The results were confirmed in the validation cohort.Conclusions: The proposed nomogram is more accurate in predicting the 90-day survival of patients with HBV-related ACLF than current commonly used methods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Derivation and Validation of a Nomogram for Predicting 90-Day Survival in Patients With HBV-Related Acute-on-Chronic Liver Failure

et al. 2021

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“…Lei et al proposed a formula model based on NLR, GGT, albumin, sodium and artificial liver support therapy to predict short-term mortality of HBV-ACLF [26]. Chen et al combined age, serum sodium and MELD score to develop a prognostic nomogram to assess 3-month mortality of HBV-ACLF, which exhibited better efficacy than MELD, MELD-Na and iMELD [27]. Lin et al developed a prognostic nomogram, on the basis of risk factors (including age, MELD and liver to abdominal area ratio), to predict 3-month mortality of HBV-ACLF, with higher prediction accuracy of 87.7% in comparison with MELD score, MELD-Na and CTP [28].…”

Section: Discussionmentioning

confidence: 99%

Artificial neural network-based models used for predicting 28- and 90-day mortality of patients with hepatitis B-associated acute-on-chronic liver failure

et al. 2020

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Background: This study aimed to develop prognostic models for predicting 28-and 90-day mortality rates of hepatitis B virus (HBV)-associated acute-on-chronic liver failure (HBV-ACLF) through artificial neural network (ANN) systems. Methods: Six hundred and eight-four cases of consecutive HBV-ACLF patients were retrospectively reviewed. Four hundred and twenty-three cases were used for training and constructing ANN models, and the remaining 261 cases were for validating the established models. Predictors associated with mortality were determined by univariate analysis and were then included in ANN models for predicting prognosis of mortality. The receiver operating characteristic curve analysis was used to evaluate the predictive performance of the ANN models in comparison with various current prognostic models. Results: Variables with statistically significant difference or important clinical characteristics were input in the ANN training process, and eight independent risk factors, including age, hepatic encephalopathy, serum sodium, prothrombin activity, γ-glutamyltransferase, hepatitis B e antigen, alkaline phosphatase and total bilirubin, were eventually used to establish ANN models. For 28-day mortality in the training cohort, the model's predictive accuracy (AUR 0.948, 95% CI 0.925-0.970) was significantly higher than that of the Model for End-stage Liver Disease (MELD), MELD-sodium (MELD-Na), Chronic Liver Failure-ACLF (CLIF-ACLF), and Child-Turcotte-Pugh (CTP) (all p < 0.001). In the validation cohorts the predictive accuracy of ANN model (AUR 0.748, 95% CI: 0.673-0.822) was significantly higher than that of MELD (p = 0.0099) and insignificantly higher than that of MELD-Na, CTP and CLIF-ACLF (p > 0.05). For 90-day mortality in the training cohort, the model's predictive accuracy (AUR 0.913, 95% CI 0.887-0.938) was significantly higher than that of MELD, MELD-Na, CTP and CLIF-ACLF (all p < 0.001). In the validation cohorts, the prediction accuracy of the ANN model (AUR 0.754, 95% CI: 0.697-0.812 was significantly higher than that of MELD (p = 0.019) and insignificantly higher than MELD-Na, CTP and CLIF-ACLF (p > 0.05).

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“…A nomogram was made using the rms package of R software (version 3.5.2; http://www-project.org), and was used to explore the contribution of PLCD genes and several clinical variables to the OS of early stage PDAC patients. The length of the corresponding line segments represents the contribution of each variable.…”

Section: Methodsmentioning

confidence: 99%

Noteworthy prognostic value of phospholipase C delta genes in early stage pancreatic ductal adenocarcinoma patients after pancreaticoduodenectomy and potential molecular mechanisms

et al. 2019

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The purpose of this investigation was to explore the prognostic value of phospholipase C delta (PLCD) genes in early stage pancreatic ductal adenocarcinoma (PDAC) and its potential molecular mechanisms. The prognostic value of PLCD genes in early stage PDAC was assessed using the Kaplan-Meier method and multivariate Cox proportional hazards regression model. Genome-wide correlation analysis was performed on PLCD3 to identify the highly correlated genes in the transcriptome. Then, PLCD3 and these correlated genes together underwent a bioinformatics analysis to elucidate the potential molecular biological functions of PLCD3 in PDAC. PLCD1 and PLCD3 are significantly overexpressed in PDAC. In PDAC patients, PLCD3 is

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A MELD-based nomogram for predicting 3-month mortality of patients with acute-on-chronic hepatitis B liver failure

Cited by 9 publications

References 27 publications

Derivation and Validation of a Nomogram for Predicting 90-Day Survival in Patients With HBV-Related Acute-on-Chronic Liver Failure

Derivation and Validation of a Nomogram for Predicting 90-Day Survival in Patients With HBV-Related Acute-on-Chronic Liver Failure

Artificial neural network-based models used for predicting 28- and 90-day mortality of patients with hepatitis B-associated acute-on-chronic liver failure

Noteworthy prognostic value of phospholipase C delta genes in early stage pancreatic ductal adenocarcinoma patients after pancreaticoduodenectomy and potential molecular mechanisms

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