Application of a biochemical and clinical model to predict individual survival in patients with end-stage liver disease
World J Gastroenterol
; 15(22): 2768-2777, June 14, 2009.
Artículo
en Inglés
| CUMED
| ID: cum-39783
Biblioteca responsable:
CU1.1
ABSTRACT
AIM:
To investigate the capability of a biochemical and clinical model, BioCliM, in predicting the survival of cirrhotic patients.METHODS:
We prospectively evaluated the survival of 172 cirrhotic patients. The model was constructed using clinical (ascites, encephalopathy and variceal bleeding) and biochemical (serum creatinine and serum total bilirubin) variables that were selected from a Cox proportional hazards model. It was applied to estimate 12-, 52- and 104-wk survival. The model¡¯s calibration using the Hosmer-Lemeshow statistic was computed at 104 wk in a validation dataset. Finally, the model¡¯s validity was tested among an independent set of 85 patients who were stratified into 2 risk groups (low risk ¡Ü 8 and high risk > 8).RESULTS:
In the validation cohort, all measures of fit, discrimination and calibration were improved when the biochemical and clinical model was used. The proposed model had better predictive values (c-statistic 0.90, 0.91, 0.91) than the Model for End-stage Liver Disease (MELD) and Child-Pugh (CP) scores for 12-, 52- and 104-wk mortality, respectively. In addition, the Hosmer-Lemeshow (H-L) statistic revealed that the biochemical and clinical model (H-L, 4.69) is better calibrated than MELD (H-L, 17.06) and CP (H-L, 14.23). There were no significant differences between the observed and expected survival curves in the stratified risk groups (low risk, P = 0.61; high risk, P = 0.77).CONCLUSION:
Our data suggest that the proposed model is able to accurately predict survival in cirrhotic patients(AU)
Texto completo:
Disponible
Colección:
Bases de datos nacionales
/
Cuba
Contexto en salud:
ODS3 - Salud y Bienestar
/
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Meta 3.2: Evitar muertes en recién nacidos y niños menores de 5 años
/
Cirrosis
/
Enfermedades del Sistema Digestivo
Base de datos:
CUMED
Asunto principal:
Bilirrubina
/
Modelos Estadísticos
/
Creatinina
/
Cirrosis Hepática
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Humanos
Idioma:
Inglés
Revista:
World J Gastroenterol
Año:
2009
Tipo del documento:
Artículo
Institución/País de afiliación:
Deparment of Gastroenterology/Cuba
/
Department of Biostatistics/Cuba
/
Department of Gastroenterology/Cuba
/
Department of Hepatology/Cuba
/
Department of Pathology/Cuba