Background and Aims:Timely and effective assessment scoring systems for predicting the mortality of patients with hepatitis E virus-related acute liver failure(HEV-ALF)are urgently needed.The present study aimed to es...Background and Aims:Timely and effective assessment scoring systems for predicting the mortality of patients with hepatitis E virus-related acute liver failure(HEV-ALF)are urgently needed.The present study aimed to establish an effective nomogram for predicting the mortality of HEV-ALF patients.Methods:The nomogram was based on a cross-sectional set of 404 HEV-ALF patients who were identified and enrolled from a cohort of 650 patients with liver failure.To compare the performance with that of the model for end-stage liver disease(MELD)scoring and CLIF-Consortiumacute-on-chronic liver failure score(CLIF-C-ACLFs)models,we assessed the predictive accuracy of the nomogram using the concordance index(C-index),and its discriminative ability using time-dependent receiver operating characteristics(td-ROC)analysis,respectively.Results:Multivariate logistic regression analysis of the development set carried out to predict mortality revealed that γ-glutamyl transpeptidase,albumin,total bilirubin,urea nitrogen,creatinine,international normalized ratio,and neutrophil-to-lymphocyte ratio were independent factors,all of which were incorporated into the new nomogram to predict the mortality of HEV-ALF patients.The area under the curve of this nomogram for mortality prediction was 0.671(95%confidence interval:0.602-0.740),which was higher than that of the MELD and CLIF-C-ACLFs models.Moreover,the td-ROC and decision curves analysis showed that both discriminative ability and threshold probabilities of the nomogram were superior to those of the MELD and CLIF-C-ACLFs models.A similar trend was observed in the validation set.Conclusions:The novel nomogram is an accurate and efficient mortality prediction method for HEV-ALF patients.展开更多
基金the National Science and Technology Major Project for Infectious Diseases(2012ZX10002004).
文摘Background and Aims:Timely and effective assessment scoring systems for predicting the mortality of patients with hepatitis E virus-related acute liver failure(HEV-ALF)are urgently needed.The present study aimed to establish an effective nomogram for predicting the mortality of HEV-ALF patients.Methods:The nomogram was based on a cross-sectional set of 404 HEV-ALF patients who were identified and enrolled from a cohort of 650 patients with liver failure.To compare the performance with that of the model for end-stage liver disease(MELD)scoring and CLIF-Consortiumacute-on-chronic liver failure score(CLIF-C-ACLFs)models,we assessed the predictive accuracy of the nomogram using the concordance index(C-index),and its discriminative ability using time-dependent receiver operating characteristics(td-ROC)analysis,respectively.Results:Multivariate logistic regression analysis of the development set carried out to predict mortality revealed that γ-glutamyl transpeptidase,albumin,total bilirubin,urea nitrogen,creatinine,international normalized ratio,and neutrophil-to-lymphocyte ratio were independent factors,all of which were incorporated into the new nomogram to predict the mortality of HEV-ALF patients.The area under the curve of this nomogram for mortality prediction was 0.671(95%confidence interval:0.602-0.740),which was higher than that of the MELD and CLIF-C-ACLFs models.Moreover,the td-ROC and decision curves analysis showed that both discriminative ability and threshold probabilities of the nomogram were superior to those of the MELD and CLIF-C-ACLFs models.A similar trend was observed in the validation set.Conclusions:The novel nomogram is an accurate and efficient mortality prediction method for HEV-ALF patients.
