Development and validation of a prognostic nomogram for acute‐on‐chronic hepatitis B liver failure

Shi, Ke‐Qing; Cai, Yiqi; Lin, Zhuo; Dong, Jin-Zhong; Wu, Jianmin; Wang, Xiaodong; Song, Mei; Wang, Yu-Qun; Chen, Yongping

doi:10.1111/jgh.13502

Cited by 15 publications

(18 citation statements)

References 39 publications

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“…In this study, the serum Na levels of patients in the poor prognosis group were significantly lower than those of the patients with a good prognosis. Low Na levels were an independent risk factor for poor prognosis of HBV-ACLF; this finding is consistent with the results of the studies of Zhang et al 15 and Shi et al 24 . The results suggest that electrolytes should be closely monitored and electrolyte imbalances should be corrected during HBV-ACLF treatment.…”

Section: Discussionsupporting

confidence: 92%

Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Lei¹,

Ao²,

Zhang³

et al. 2017

Clinics

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OBJECTIVE:To investigate the impact of the baseline status of patients with hepatitis B virus-associated acute-on-chronic liver failure on short-term outcomes.METHODS:A retrospective study was conducted that included a total of 138 patients with hepatitis B virus-associated acute-on-chronic liver failure admitted to the Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, from November 2013 to October 2016. The patients were divided into a poor prognosis group (74 patients) and a good prognosis group (64 patients) based on the disease outcome. General information, clinical indicators and prognostic scores of the patients’ baseline status were analyzed, and a prediction model was established accordingly.RESULTS:Elder age, treatment with artificial liver support systems and the frequency of such treatments, high levels of white blood cells, neutrophils, neutrophil count/lymphocyte count ratio, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, urea, and prognostic scores as well as low levels of albumin and sodium were all significantly associated with the short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure. The predictive model showed that logit (p) = 3.068 + 1.003 × neutrophil count/lymphocyte count ratio - 0.892 × gamma-glutamyl transferase - 1.138 × albumin - 1.364 × sodium + 1.651 × artificial liver support therapy.CONCLUSION:The neutrophil count/lymphocyte count ratio and serum levels of gamma-glutamyl transferase, albumin and sodium were independent risk factors predicting short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure, and the administration of multiple treatments with artificial liver support therapy during the early stage is conducive to improved short-term outcomes.

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Section: Discussionsupporting

confidence: 92%

Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Lei¹,

Ao²,

Zhang³

et al. 2017

Clinics

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“…It was defined by EASL-CLIF Consortium, but was not applied to patients who met APASL criteria [24]. Besides, Wu et al, Yan et al, and Shi et al have successively established the Logistic regression model, Cox regression model, classification and regression trees, and nomogram prognostic model for APASL ACHBLF [25][26][27][28]. However, these models were established in retrospective single-center studies, which have not been compared with the CLIF-C ACLFs, and validated in patients who met EASL-CLIF criteria.…”

Section: Discussionmentioning

confidence: 99%

Nomogram prediction of individual prognosis of patients with acute-on-chronic hepatitis B liver failure

Gao

Zhang

Liu

et al. 2019

Digestive and Liver Disease

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“…The predictive ability of the nomogram is more reflective of the final ACLF grade before LT than ACLF grade at registration. If patients with ACLF grade 3 at registration downgrade to ACLF grades 0-2 before LT, the nomogram score will be lower in line with the decreased Nomograms are regularly used pictorial tools to estimate prognosis and have been shown to be more accurate than traditional models in predicting individualized risk in ACLF and acute decompensation (13,31). This study constructed and internally validated a novel nomogram including WBC count, ALT/AST ratio, and the organ failure numbers.…”

Section: Discussionmentioning

confidence: 92%

A nomogram to predict survival in patients with acute-on-chronic hepatitis B liver failure after liver transplantation

Chen¹,

Zhang²,

Lu³

et al. 2021

Ann Transl Med

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Background: Individualized prediction of survival after liver transplantation (LT) for patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) has not been well investigated. This study aimed to develop a prognostic nomogram for patients with HBV-ACLF undergoing LT. Methods: The nomogram was derived from a retrospective study of 290 patients who underwent LT for HBV-ACLF at the Third Affiliated Hospital of Sun Yat-sen University between January 2012 and December 2017. Concordance index and determiner calibration curve was used to ascertain the predictive accuracy and discriminative ability of the nomogram. The predictive performance of the nomogram was compared with that of Child-Pugh score, model for end-stage liver disease (MELD), MELD-Na, chronic liver failure Consortium Organ Failure score (CLIF-C OFs), and CLIF-C ACLF.Results: The 1-year mortality rate was 23.1% (67/290). The Cox multivariate analysis showed that risk factors for 1-year survival rate included white blood cell count, alanine aminotransferase/aspartate aminotransferase ratio, and the organ failure numbers. The determiner calibration curve showed good agreement between prediction of the nomogram and actual observation. The concordance index of the nomogram for predicting 1-year survival was 0.707, which was significantly higher than that of other prognostic models: Child-Pugh score (0.626), MELD (0.627), MELD-Na (0.583), CLIF-C OF (0.674), and comparable to that of CLIF-C ACLF (0.684). Conclusions:Our study developed a novel nomogram that could accurately predict individualized posttransplantation survival in patients with HBV-ACLF. The nomogram might be a useful tool for identifying HBV-ACLF patients who would benefit from LT.

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Development and validation of a prognostic nomogram for acute‐on‐chronic hepatitis B liver failure

Abstract: The prognostic nomogram provided an individualized risk estimate of short-term survival in patients with ACHBLF, offering to clinicians to improve their abilities to assess patient prognosis.

Cited by 15 publications

References 39 publications

Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Nomogram prediction of individual prognosis of patients with acute-on-chronic hepatitis B liver failure

A nomogram to predict survival in patients with acute-on-chronic hepatitis B liver failure after liver transplantation

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