A novel dynamic model for predicting outcome in patients with hepatitis B virus related acute-on-chronic liver failure

作者：Xue, Ran; Duan, Zhonghui; Liu, Haixia; Chen, Li; Yu, Hongwei; Ren, Meixin; Zhu, Yueke; Jin, Chenggang; Han, Tao; Gao, Zhiliang; Meng, Qinghua^*

来源：Oncotarget, 2017, 8(65): 108970-108980.

DOI：10.18632/oncotarget.22447

• acute-on-chronic liver failure
• hepatitis B
• prognostic model

Aim: It is challenging to predict the outcome of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) through existing prognostic models. Our aim was to establish a novel dynamic model to improve the predictive efficiency of 30-day mortality in HBV-ACLF patients.
Methods: 305 patients who were diagnosed as HBV-ACLF (derivation cohort, n= 211; validation cohort, n= 94) were included in this study. The HBV-ACLF dynamic (HBV-ACLFD) model was constructed based on the daily levels of predictive variables in 7 days after diagnosis combined with baseline risk factors by multivariate logistic regression analysis. The HBV-ACLFD model was compared with the Child-Turcotte-Pugh (CTP) score, end-stage liver disease (MELD) score, and MELD within corporation of serum sodium (MELD-Na) score by the area under the receiver-operating characteristic curves (AUROC).
Results: The HBV-ACLFD model demonstrated excellent discrimination with AUROC of 0.848 in the derivation cohort and of 0.813 in the validation cohort (p= 0.620). The performance of the HBV-ACLFD model appeared to be superior to MELD score, MELD-Na score and CTP score (P< 0.0001).
Conclusion: The HBV-ACLFD model can accurately predict 30-day mortality in patients with HBV-ACLF, which is helpful to select appropriate clinical procedures, so as to relieve the social and economic burden.

• 出版日期2017-12-12
• 单位中山大学; 天津医科大学; 首都医科大学; 北京师范大学