Novel Prognostic Models for Predicting the 180-Day Outcome for Patients with Hepatitis-B Virus-related Acute-on-chronic Liver Failure

Xue, Ran; Yang, Jun; Wu, Jing; Wang, Zhongying; Meng, Qingying

doi:10.14218/jcth.2021.00028

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…In our future prospective studies, we will make further comparisons with the AARC score. 22,23 In conclusion, the nomogram prediction model based on target parameters may play a key role in clinical application for 90-day prognosis prediction for patients with HBV-ACLF.…”

Section: Characteristicsmentioning

confidence: 99%

Development and Validation of a Nomogram for 90-day Outcome in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure

Yang¹,

Xue²,

Wu³

et al. 2021

J Clin Transl Hepatol

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Background and Aims:It is challenging to predict the 90-day outcomes of patients infected with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) via prevailing predictive models. This study aimed to develop an innovative model to enhance the analytical efficacy of 90-day mortality in HBV-ACLF. Methods: In this study, 149 HBV-ACLF patients were evaluated by constructing a death risk prediction nomogram. Bootstrap resampling and an independent validation cohort comprising 31 patients from June 2019 to February 2020 were assessed for model confirmation. Results: The nomogram was constructed by entering and identifying five factors (age, total bilirubin, prothrombin activity (PTA), lymphocyte (L)%, and monocyte (M)%. Healthy refinement was achieved from the nomogram analysis, where the area under the receiver operating characteristic curve was 0.864 for the training cohort and 0.874 was achieved for the validation cohort. There was admirable concordance between the predicted and true results in the equilibrium curve. The decision curve assessment revealed the useful clinical application of the nomogram. Conclusions: We constructed an innovative nomogram and validated it for the prediction of 90-day HBV-ACLF patient outcomes. This model might help develop optimized treat-ment protocol recommendations for HBV-ACLF patients.

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Section: Characteristicsmentioning

confidence: 99%

Development and Validation of a Nomogram for 90-day Outcome in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure

Yang¹,

Xue²,

Wu³

et al. 2021

J Clin Transl Hepatol

Self Cite

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“…Table 3 lists the features of the studies that were employed as the risk factors for the mortality of HBV-ACLF. 5 studies were case–control studies [ 12 , 27 , 33 , 35 , 36 ], and the others were cohort studies [ 13 – 15 , 24 – 26 , 28 – 32 , 34 , 37 – 41 ]. In general, 10,878 cases of HBV-ACLF were covered in the cohort studies, which were published between 2015 and 2022.…”

Section: Resultsmentioning

confidence: 99%

Risk factors for the mortality of hepatitis B virus-associated acute-on-chronic liver failure: a systematic review and meta-analysis

Tu,

Liu,

Zhang

et al. 2023

BMC Gastroenterol

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Background Hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) has been confirmed as a prevalent form of end-stage liver disease in people subjected to chronic HBV infection. However, there has been rare in-depth research on the risk factors for the mortality of HBV-ACLF. This study aimed at determining the risk factors for the mortality of HBV-ACLF. Methods The relevant research was selected from four electronic databases that have been published as of August 2023. The existing research was reviewed in accordance with the inclusion and exclusion criteria. The level of quality of previous research was evaluated using the Newcastle–Ottawa scale. Moreover, a pooled estimate of the odds ratios (ORs) with their associated 95% confidence intervals (CIs) was provided through a meta-analysis. The data were combined, and the risk variables that at least two studies had considered were analyzed. The publication bias was examined through Egger's test and Begg's test. Results Twenty two studies that conformed to the inclusion criteria were selected from 560 trials. Eight risk variables in terms of HBV-ACLF mortality were determined, which covered INR (OR = 1.923, 95% CI = 1.664–2.221, P < 0.001), Monocytes (OR = 1.201, 95% CI = 1.113–1.296, P < 0.001), Cirrhosis (OR = 1.432, 95% CI = 1.210–1.696, P < 0.001), HE (OR = 2.553, 95% CI = 1.968–3.312, P < 0.001), HE grade (OR = 2.059, 95% CI = 1.561–2.717, P < 0.001), SBP (OR = 1.383, 95% CI = 1.080–1.769, P = 0.010), Hyponatremia (OR = 1.941, 95% CI = 1.614–2.334, P < 0.001), as well as HRS (OR = 2.610, 95% CI = 1.669–4.080, P < 0.001). Conclusion The most significant risk factors for HBV-ACLF mortality comprise HRS, HE, and HE grade, followed by INR and hyponatremia. The Monocytes, cirrhosis, and SBP have been confirmed as the additional key risk factors for HBV-ACLF mortality.

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Hypermethylation of the glutathione peroxidase 4 promoter predicts poor prognosis in patients with hepatitis B virus-associated acute-on-chronic liver failure

Su,

Han,

Wang

et al. 2024

Front. Mol. Biosci.

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BackgroundHepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is a syn-drome with a high short-term mortality rate, and its prognosis is critical in clinical management. This study aimed to investigate the clinical significance of glutathione peroxidase 4 (GPX4) in the occurrence and development of HBV-ACLF and its prognostic value for 90-day mortality.MethodsThe expression levels of GPX4, oxidative stress-related molecules and inflammatory cytokines in serum or peripheral blood mononuclear cells (PBMCs) of 289 participants were determined by RT-qPCR or ELISA, and the methylation level of GPX4 promoter in PBMCs was determined by MethyLight.ResultsThe expression levels of GPX4 in the PBMCs and serum of HBV-ACLF patients were lower than those in non-HBV-associated acute-on-chronic liver failure (non-HBV ACLF) patients, patients with chronic hepatitis B (CHB) and healthy control (HC) individuals, while the methylation level of the GPX4 promoter was greater. In HBV-ACLF patients, the methylation level of the GPX4 promoter is correlated with oxidative stress, inflammation-related molecules, and some clinicopathological indicators. The methylation level of the GPX4 promoter was identified as an independent risk factor for 90-day mortality in HBV-ACLF patients and yielded a larger area under the receiver operating characteristic curve (AUROC) than the model for end-stage liver disease (MELD) score in predicting 90-day mortality.ConclusionThe GPX4 promoter methylation level has promising potential as a predictor of 90-day mortality in patients with HBV-ACLF.

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Novel Prognostic Models for Predicting the 180-Day Outcome for Patients with Hepatitis-B Virus-related Acute-on-chronic Liver Failure

Cited by 3 publications

References 21 publications

Development and Validation of a Nomogram for 90-day Outcome in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure

Development and Validation of a Nomogram for 90-day Outcome in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure

Risk factors for the mortality of hepatitis B virus-associated acute-on-chronic liver failure: a systematic review and meta-analysis

Hypermethylation of the glutathione peroxidase 4 promoter predicts poor prognosis in patients with hepatitis B virus-associated acute-on-chronic liver failure

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