External validation and comparison of six prognostic models in a prospective cohort of HBV-ACLF in China

Journal Title: Annals of Hepatology - Year 2016, Vol 15, Issue 2

Abstract

Background. Acute-on-chronic liver failure has high mortality. Currently, robust models for predicting the outcome of hepatitis B virus (HBV)-associated ACLF are lacking. Aim. To assess and compare the performance of six prevalent models for short- and longterm prognosis in patients with HBV-ACLF. Material and methods. The model for end-stage liver disease (MELD), MELDsodium (MELD-Na), MELD to sodium ratio (MESO), integrated MELD, Child-Turcotte-Pugh (CTP), and modified CTP (mCTP) werevalidated in a prospective cohort of 232 HBV-ACLF patients. The six models were evaluated by determining discrimination, calibration and overall performance at 3 months and 5 years. Results. According to the Hosmer-Lemeshow tests and calibration plots, all models could adequately describe the data except CTP at 3 months. Discrimination analysis showed that the iMELD score had the highest AUC of 0.76 with sensitivity of 62.6% and specificity of 80.2% for an optimal cut-off value of 52 at 3 months. It also had the highest AUC of 0.80 with sensitivity of 89.9% and specificity of 48.2% for an optimal cut-off value of 43 at 5 years. The overall performance of iMELD, assessed with Nagelkerke’s R2 and the Brier score, was also the best among the six models. Conclusion. Integrated MELD may be the best model to predict short- and long-term prognosis in patients with HBV-ACLF.

Authors and Affiliations

Yi Shen, Yan-Mei Liu, Bin Wang, Yong-Gen Zhu, Yuan-Yuan Wang, Xu-Lin Wang, Ju-Ling Ji, Jian-Guo Shao, Yan Qin, Gang Qin

Keywords

Related Articles

Most overweight and obese Indian children have nonalcoholic fatty liver disease

Background and rationale. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease in western countries. Its prevalence in Indian subcontinent is not well studied. Material and method...

Steatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study

Introduction. Steatotic livers have been associated with greater risk of allograft dysfunction in liver transplantation. Our aim was to determinate the prevalence of steatosis in grafts from deceased donors in Chile and...

Diagnostic accuracy of magnetic resonance elastography in liver transplant recipients: A pooled analysis

Background and aims. We conducted an individual participant data (IPD) pooled analysis on the diagnostic accuracy of magnetic resonance elastography (MRE) to detect fibrosis stage in liver transplant recipients. Materia...

PTEN at the crossroad of metabolic diseases and cancer in the liver

The tumor suppressor PTEN is a phosphoinositide phosphatase regulating the PI3K/Akt signaling pathways and mutated or deleted in a variety of human cancers. Recent evidence indicates that dysregulated PTEN expression and...

Download PDF file
  • EP ID EP78561
  • DOI -
  • Views 114
  • Downloads 0

How To Cite

Yi Shen, Yan-Mei Liu, Bin Wang, Yong-Gen Zhu, Yuan-Yuan Wang, Xu-Lin Wang, Ju-Ling Ji, Jian-Guo Shao, Yan Qin, Gang Qin (2016). External validation and comparison of six prognostic models in a prospective cohort of HBV-ACLF in China. Annals of Hepatology, 15(2), 236-245. https://europub.co.uk/articles/-A-78561