Development of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure Undergoing Liver Transplantation
单位:[1]Beijing Friendship Hospital, Capital Medical University, Beijing, PR China 首都医科大学附属北京友谊医院[2]General Surgical Center, Beijing Youan Hospital, Capital Medical University, Beijing, PR China
BACKGROUND We aimed to create a novel predictive model through comparing the prognostic accuracy of the current mainstream scoring models in predicting the short-term outcome of patients with hepatitis B-related acute-on-chronic liver failure (HBACLF) undergoing liver transplantation (LT). MATERIAL AND METHODS Data on patients with HBACLF undergoing LT were retrospectively collected and analyzed. The area under the time-dependent receiver operating characteristic curve of 16 scoring models was calculated to evaluate their performance in predicting short-term survival after LT. Univariate analyses and LASSO regression were used to identify the independent variables, which were further selected by Cox stepwise regression. RESULTS A total of 135 patients were enrolled. Among the 16 scoring models, MELD-Na performed the best in predicting 3-month mortality after LT, with an AUC of 0.716. LASSO regression analysis revealed that only the MELD-Na was confirmed as an independent predictor (HR 1.0481, 95% C.I [1.0136, 1.0838], P<0.05). Cox stepwise regression identified 4 variables - MELD-Na, sex, systemic infection, and placement of T-tube during operation - which were used to construct a novel prognostic model with a C-index of 0.844 and a Brier score of 0.131 after internal validation and a C-index of 0.824 (95% C.I [0.658, 0.989]) and a Brier score of 0.119 in the external validation cohort at 3 months. CONCLUSIONS Compared with other scoring models, MELD-Na was an independent factor in predicting short-term outcome after LT. The constructed novel predictive model could exert clinical benefits on early prognostic assessment and case selection.
第一作者单位:[1]Beijing Friendship Hospital, Capital Medical University, Beijing, PR China [2]General Surgical Center, Beijing Youan Hospital, Capital Medical University, Beijing, PR China
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推荐引用方式(GB/T 7714):
Zhang Qikun,Wang Menglong,Li Guangming,et al.Development of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure Undergoing Liver Transplantation[J].Annals Of Transplantation.2022,27:e936732.doi:10.12659/AOT.936732.
APA:
Zhang Qikun,Wang Menglong,Li Guangming&Zhang Zhongtao.(2022).Development of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure Undergoing Liver Transplantation.Annals Of Transplantation,27,
MLA:
Zhang Qikun,et al."Development of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure Undergoing Liver Transplantation".Annals Of Transplantation 27.(2022):e936732