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

作者：Chen, Rui-Cong; Wang, Xiao-Dong; Dong, Jin-Zhong; Lin, Zhuo; Wu, Jian-Min; Cai, Yi-Jing^*; Shi, Ke-Qing^*

来源：Clinica Chimica Acta, 2017, 468: 195-200.

DOI：10.1016/j.cca.2017.03.005

• Acute-on-chronic hepatitis B liver failure
• Nomogram
• Prediction
• Calibration
• Receiver operating characteristics
• Decision curve

Background: Acute-on-chronic hepatitis B liver failure (ACHBLF) is associated with poor short-term prognosis. The aim of the present study was to construct and validate a model for end-stage liver disease (MELD)-based no-mogram for the 3-month mortality estimation for patients with ACHBLF. @@@ Methods: A total of 551 patients with ACHBLF were prospectively enrolled from 2 independent medical centers and divided into 2 cohorts of training and validation, respectively. The 3-month mortality was recorded as the outcome. The MELD-based nomogram was constructed to predict the 3-month mortality for ACHBLF using the training group of 335 patients and validated using an independent cohort of 216 patients. The predictive capability of MELD-based nomogram was compared with the MELD score system by calibration analysis, receiver operating characteristics (ROC) and decision curve analysis in both training cohort and validation cohort. @@@ Results: Multivariate analysis suggested that age, serum sodium, and MELD score were independent prognostic indicators associated with the 3-month mortality for ACHBLF, and therefore used for developing the nomogram. In terms of calibration, the predicted survival by the MELD-based nomogram was found to be extremely in line with the observed 3-month mortality both in training cohort and validation cohort. Additionally, both ROC and decision curve analyses showed that the MELD-based nomogram was better than MELD, MELD-Na, MELDNa, and iMELD for ACHBLF prognosis prediction. The results were confirmed in the external cohort of validation. @@@ Conclusions: The MELD-based nomogram provided a user-friendly, accurate and reproducible tool for predicting 3-month mortality of patients with ACHBLF.

• 出版日期2017-5
• 单位温州医科大学