Back to Search
Start Over
A Dynamic Model for Predicting Outcome in Patients with HBV Related Acute-On-Chronic Liver Failure.
- Source :
-
Annals of hepatology [Ann Hepatol] 2018 May-June; Vol. 17 (3), pp. 392-402. Date of Electronic Publication: 2018 Apr 09. - Publication Year :
- 2018
-
Abstract
- Introduction and Aim: Accurately predicting the prognosis of individual patient is crucial in the management of ACLF. We aimed to establish a specific prognostic model for HBV-related ACLF patients treated with nucleoside analog (NA).<br />Material and Methods: We prospectively collected 205 ACLF cases diagnosed according to the APASL criteria. A dynamic prognostic model based on APASL criteria was established and validated. To demonstrate that the model is also applicable to those within EASL criteria, we divided the patients into two groups: met APASL criteria only (group A, n = 123); met both APASL and EASL criteria (group B, n = 82). Its prognostic accuracy was also compared with chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score in group B.<br />Results: The model is: R = 0.94 x Bilirubin + 0.53 x evolution of Bilirubin - 0.45 x PT-A - 0.22 x evolution in PT-A -0.1 x PLT + 10 x anti-HBe. The area under receiver operating characteristic curve (AUC) of the model for predicting 90-day mortality was 0.86, which was significantly higher than that of model for end stage liver disease(MELD), MELD-Na, CLIF-SOFA, ΔMELD (7d) and ΔMELD-Na (7d), ΔCLIF- SOFA(7d) (all p &lt; 0.01). The AUC of our model in the validation group was 0.79 which was superior to MELD (0.45) CLIF-SOFA (0.53) score in group B patients (p &lt; 0.01).<br />Conclusion: In conclusion, the model was superior to the conventional methods in predicting the outcomes of patients with HBV related ACLF treated with NA. It is the first description of a novel prognostic model using consecutive data in patients with HBV-induced acute-on-chronic liver failure (ACLF) treated by nucleoside analogs.
- Subjects :
- Acute-On-Chronic Liver Failure diagnosis
Acute-On-Chronic Liver Failure mortality
Acute-On-Chronic Liver Failure virology
Adult
Antiviral Agents adverse effects
Bilirubin blood
Biomarkers blood
China
Disease Progression
Female
Hepatitis B Antibodies blood
Hepatitis B e Antigens immunology
Hepatitis B virus immunology
Hepatitis B virus pathogenicity
Hepatitis B, Chronic diagnosis
Hepatitis B, Chronic mortality
Hepatitis B, Chronic virology
Humans
Male
Middle Aged
Nucleosides adverse effects
Organ Dysfunction Scores
Predictive Value of Tests
Prospective Studies
Prothrombin metabolism
Reproducibility of Results
Time Factors
Treatment Outcome
Acute-On-Chronic Liver Failure drug therapy
Antiviral Agents therapeutic use
Decision Support Techniques
Hepatitis B virus drug effects
Hepatitis B, Chronic drug therapy
Models, Biological
Nucleosides therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1665-2681
- Volume :
- 17
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Annals of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 29735787
- Full Text :
- https://doi.org/10.5604/01.3001.0011.7383