Recompensation factors for patients with decompensated cirrhosis: a multicentre retrospective case–control study

Abstract

ObjectivesWe aimed to evaluate recompensation factors among patients with decompensated cirrhosis.DesignA multicentre retrospective case–control study was conducted. Data were collected from and compared between groups of patients with recompensated and acute decompensated cirrhosis. Univariable and multivariable logistic regressions were used to select indicators associated with recompensation among patients with decompensated cirrhosis with different complications. A decision tree with 10-fold cross-validation was used to develop the model to identify patients with recompensation. We followed the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guideline for development and reporting of the new model.SettingThe study was conducted in six tertiary public hospitals in Chongqing, China.ParticipantsThis study included 3953 patients with decompensated cirrhosis.ResultsIn the total sample of included patients, there were 553 patients with recompensation and 3400 patients with acute decompensation, including 1158 patients with gastrointestinal bleeding, 1715 patients with a bacterial infection, 104 patients with hepatic encephalopathy and 423 patients with ascites. The most relevant indicator of recompensation selected by the decision tree model was albumin, with a threshold of 40 g/L. Total protein, haemoglobin, basophil percentage, alanine aminotransferase, neutrophil-to-lymphocyte ratio and diabetes were also selected to subsequently distinguish patients. The terminal nodes with a probability of recompensation was 0.89. The overall accuracy rate of the model was 0.92 (0.91–0.93), and it exhibited high specificity (86.9%) and sensitivity (92.6%).ConclusionsThe occurrence of recompensated cirrhosis could be identified by albumin, total protein, haemoglobin, basophil percentage, alanine aminotransferase, neutrophil-to-lymphocyte ratio and diabetes. These simple variables may help clinicians develop a treatment plan to encourage patients with decompensated cirrhosis to recompensate.

Predicting diabetic kidney disease for type 2 diabetes mellitus by machine learning in the real world: a multicenter retrospective study

“…The data originated from Chongqing Medical University’s Medical Data Intelligence Platform(Yidu-Cloud (Beijing) Technology Co, Ltd, China), which consisted of the data from seven institutions and over 40 million electronic medical records (during 1 January 2010 to 31 May 2020) ( 21 – 23 ). Only the information from the first hospitalization was applied in the event of subsequent hospitalizations.…”

Recompensation in Cirrhosis: Current Evidence and Future Directions

“…In view of an evolving concept, we conducted a systematic search of literature using the terms "recompensation", "cirrhosis" "chronic liver disease" in different Boolean combinations in MEDLINE, EMBASE and gray literature search of Google Scholar. An analysis of the literature shows only two studies which specifically indicate towards a criteria for recompensation while others focus on the outcome of delisting from transplant waitlist especially in HCV cohorts 14,15 . A summary of selected studies is shown in Table 1.…”

Development and validation of a prognostic model for 90‐day survival in patients with alcohol‐associated cirrhosis and acute decompensation

“…7 Some previous studies have proposed models related to the prognosis of patients with cirrhosis and AD. 8,9 However, these studies are limited to exploring hospitalization rates and the long-term prognosis of patients with cirrhosis and AD. Consequently, an accurate assessment of the survival risk of these patients is still lacking.…”

“…In addition, alcohol as a risk factor can have an important impact on the progression of AD 7 . Some previous studies have proposed models related to the prognosis of patients with cirrhosis and AD 8,9 . However, these studies are limited to exploring hospitalization rates and the long‐term prognosis of patients with cirrhosis and AD.…”