Prognostic nomogram for acute-on-chronic hepatitis B liver failure

Lin, Su; Chen, Juan; Wang, Mingfang; Han, Lijing; Zhang, Haoyang; Dong, Jing; Zeng, Da‐Wu; Jiang, Jiaji; Zhu, Yueyong

doi:10.18632/oncotarget.21012

Cited by 16 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are studies estimating the severity and outcomes of HBACLF by establishing prognostic scoring models. Previous studies illustrated that the liver volume [ 19 ], lymphocyte-monocyte ratio [ 20 ], albumin-bilirubin score [ 21 ], logistic regression model [ 22 ], macrophage inflammatory protein 3 α [ 23 ], and other methods [ 24 – 26 ] could be simple and sensitive models to evaluate the severity and prognosis of ACLF, which would be practically useful in clinic. Those methods mainly concentrated on the severity of liver injury, and the parameters in those models were generally to reflect the condition of liver function.…”

Section: Discussionmentioning

confidence: 99%

Alpha-Fetoprotein as a Predictive Marker for Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure

Wang

Jiao

Yang

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

Background and Aims The value of alpha-fetoprotein (AFP) in hepatitis B-related acute-on-chronic liver failure (HBACLF) is not fully understood. The present study aimed to evaluate the prognostic effect of AFP on the prediction of HBACLF outcomes. Methods We investigated a cohort of patients with HBACLF admitted from January 2013 to May 2017. The endpoint of followup was 180 days, death, or liver transplantation. AFP concentrations were estimated on admission. To make statistical comparisons, we used chi-squared test, receiver operating characteristic (ROC) curve analysis, survivorship curve analysis, and Cox proportional-hazards model. Results A total of 92 patients (81.5% male, median age of 46 years) were included. Overall survival rate within 180 days was 43.48%, and the value of log10AFP⁡ ≥ 2.04 indicated a better prognosis with 76.9% specificity and 62.5% sensitivity for patients with HBACLF. Age (HR 1.041), total bilirubin (HR 1.004), log10AFP⁡ (HR 2.155), and INR (HR 1.446) were found to be risk factors of survival. Conclusion AFP could be a useful marker to predict outcomes of acute-on-chronic liver failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Alpha-Fetoprotein as a Predictive Marker for Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure

Wang

Jiao

Yang

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

show abstract

“…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%

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

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

“…Previous studies had shown that nomogram enabled more-accurate individualized prediction of survival than MELD, MELD-Na, CTP, sequential organ failure assessment, or CLIF-C scores for HBV patients and demonstrated superior net benefits over other score models[ 25 , 26 ]. Therefore, an effective prognostic nomogram for ACLF patients was established, as shown in Figure 1 ; the nomogram of our study could accurately predict 1- and 2-mo survival in patients with ACLF.…”

Section: Discussionmentioning

confidence: 99%

Effect of type 2 diabetic mellitus in the prognosis of acute-on-chronic liver failure patients in China

Lai¹,

Chen²,

Hu³

et al. 2021

WJG

View full text Add to dashboard Cite

BACKGROUND Acute-on-chronic liver failure (ACLF) patients have a high short-term mortality rate, and the severity evaluation of ACLF is necessary for prognostication. Therefore, it was meaningful to evaluate the association between type 2 diabetic mellitus (DM) and ACLF and further explore the feasibility of using DM as a prognostic indicator in ACLF patients. The association between type 2 DM and the prognosis of patients with severe liver disease remains unclear. AIM To examine the effect of type 2 DM on the prognosis of patients with ACLF. METHODS Clinical data from 222 ACLF patients were collected and analyzed. The patients were categorized into two groups depending on whether they had DM or not, and the clinical data of ACLF patients were measured within 48 h after admission. Complications of ACLF were documented during treatment, such as hepatic encephalopathy, hepatorenal syndrome, acute upper gastrointestinal hemorrhage, and spontaneous peritonitis (SBP). Values of laboratory parameters, complication rates, and hospital mortality rates were compared between two groups. RESULTS Among 222 ACLF patients, 38 cases were categorized into DM groups, the mean age was 56.32 years and 73.68% were male. The prognosis of ACLF patients was significantly correlated with DM in univariate [hazard ratio (HR) = 2.4, 95% confidence interval (CI) =1.5-3.7, P < 0.001] and multivariable analysis (HR = 3.17, 95%CI =1.82-5.523, P < 0.001). The incident of SBP (34.21% vs 13.59%, P = 0.038) and other infections like lung, urinary, blood, and cholecyst (44.74% vs 28.26%, P = 0.046) were higher in DM patients than non-DM counterparts. In addition, the ACLF patients with DM tended to have a high mortality rate ( P < 0.001). Cumulative survival time was also significantly shorter in the ACLF patients with DM than non-DM. CONCLUSION A significant association between DM and the prognosis of ACLF patients was found in China. The ACLF patients with DM had higher incidence of hospital mortality and infection than those without DM.

show abstract

Prognostic nomogram for acute-on-chronic hepatitis B liver failure

Cited by 16 publications

References 30 publications

Alpha-Fetoprotein as a Predictive Marker for Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure

Alpha-Fetoprotein as a Predictive Marker for Patients with Hepatitis B-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

Effect of type 2 diabetic mellitus in the prognosis of acute-on-chronic liver failure patients in China

Contact Info

Product

Resources

About