Oncotarget

Clinical Research Papers:

Prognostic nomogram for acute-on-chronic hepatitis B liver failure

Su Lin, Juan Chen, Mingfang Wang, Lifen Han, Haoyang Zhang, Jing Dong, Dawu Zeng, Jiaji Jiang and Yueyong Zhu _

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Oncotarget. 2017; 8:109772-109782. https://doi.org/10.18632/oncotarget.21012

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Abstract

Su Lin1,*, Juan Chen2,*, Mingfang Wang1, Lifen Han3, Haoyang Zhang4, Jing Dong1, Dawu Zeng1, Jiaji Jiang1 and Yueyong Zhu1

1Liver Research Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China

2Digestive System Department, Fujian Provincial Hospital, Fuzhou, Fujian, China

3Department of Infectious Disease, Meng Chao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China

4Division of Biostatistics, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hongkong, China

*These authors contributed equally to this work

Correspondence to:

Yueyong Zhu, email: [email protected]

Keywords: prognosis, survival, liver to abdominal area ratio (LAAR), model for end-stage liver disease (MELD) score, age

Received: January 25, 2017     Accepted: August 28, 2017     Published: September 18, 2017

ABSTRACT

Background & Aims: To establish an effective prognostic nomogram for acute-on-chronic hepatitis B liver failure (ACHBLF).

Materials and Methods: The nomogram was based on clinical data of 203 ACHBLF patients who admitted to the First Affiliated Hospital of Fujian Medical University from 2009 to 2014. The area under the receiver-operating characteristic curve (AUC) and calibration curve were carried out to verify the predictive accuracy ability of the nomogram. The result was validated in internal and external validation cohorts. Kaplan-Meier survival curve was used in survival analysis.

Results: We developed a new prognostic nomogram to predict 3-month mortality based on risk factors selected by multivariate analysis. This nomogram consisted three independent factors: age, liver to abdominal area ratio (LAAR) and model for end-stage liver disease (MELD) score. The AUC of this nomogram for survival prediction was 0.877 (95% CI 0.831–0.923), which was higher than that of MELD score, MELD-Na and Child-Turcotte-Pugh (CTP). Good agreement of calibration plot for the probability of survival at 3-month was shown between the prediction by nomogram and actual observation. These results were supported by internal and external validation studies.

Conclusions: The ACHBLF nomogram could predict the short-term survival for ACHBLF patients.


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