Prediction model of the progression of patients with acute deterioration of hepatitis B virus-related chronic liver disease to acute-on-chronic liver failure.
Medicine (Baltimore)
; 97(34): e11915, 2018 Aug.
Article
en En
| MEDLINE
| ID: mdl-30142800
ABSTRACT
This study aimed to establish a new model for predicting acute-on-chronic liver failure (ACLF) (defined by the Chinese Medical Association), which potentially occurs among patients with acute deterioration (AD) of hepatitis B virus (HBV)-related chronic liver disease (CLD).A total of 754 patients with AD of HBV-related CLD (total bilirubin (TBIL) > 51.3âµmol/L and prothrombin activity (PTA)â<â60%, 40%â<âPTAâ<â60% when TBILâ≥â171.1âµmol/L) were retrospectively analyzed and divided into a training cohort (580 patients) and a validation cohort (174 patients). The ACLF occurrence probability of these patients was statistically analyzed within 4 weeks. In the training cohort, multivariate logistic regression analysis was performed to determine the independent predictors of ACLF occurrence and to develop a new prediction model. The validation cohort was utilized to verify and evaluate the value of the new prediction model.Within 4 weeks, 9.9% of the patients progressed to ACLF (12.0â±â6.7 days). The new prediction model was characterized by Râ=â3.090â+â0.035â×âAge (years)â-â0.050â×âPTA (%)â+â0.005â×âTBIL (µmol/L)â+â0.044â×âD/T (%)â-â0.072â×âNa (mmol/L)â+â0.180â×âHBV DNA (log10IU/mL). The areas under the receiver operating characteristic curves of the training and validation cohorts in the new model were higher than those in the model for end-stage liver disease.The new prediction model could be used by clinicians to recognize patients with AD of HBV-related CLD with high risks of progressing to ACLF.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hepatitis B Crónica
/
Insuficiencia Hepática Crónica Agudizada
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2018
Tipo del documento:
Article