Development and Validation of a Prognostic Nomogram Based on Fibrosis-4 Index to Predict 3-Month Mortality in Patients with Hepatic Encephalopathy
| Author | Yunxuan Guan | en |
| Author | Kai Liu | en |
| Author | Xiujun Zhang | en |
| Author | Caoyan Qi | en |
| Author | Xiaolu Chen | en |
| Author | Wenhui Zhang | en |
| Author | Yan Chen | en |
| Author | Yu Ma | en |
| Author | Lina Pu | en |
| Author | Jiahong Yuan | en |
| Author | Niansen Lu | en |
| Author | Chaochao Zhang | en |
| Author | Yuan Xue | en |
| Orcid | Yuan Xue [0000-0002-5428-0058] | en |
| Issued Date | 2023-12-31 | en |
| Abstract | Background: Hepatic encephalopathy is a severe neuropsychiatric complication of decompensated cirrhosis associated with high short-term mortality. Objectives: This study aimed to evaluate the predictive value of non-invasive scoring systems and develop a prognostic nomogram to identify the risk of 3-month mortality in patients with hepatic encephalopathy. Methods: Retrospective data from 251 patients with decompensated cirrhosis and hepatic encephalopathy were collected. Clinical data and non-invasive scoring systems were compared between survivors and non-survivors using univariate and multivariate logistic regression analyses. A prognostic model was developed and validated using bootstrap resampling procedures. Results: Among the 251 patients, 40 (15.9%) died within three months. The non-survivor group had a higher incidence of complications and higher non-invasive scores (all P < 0.01). Multivariate analysis revealed that hepatorenal syndrome, spontaneous bacterial peritonitis, upper gastrointestinal bleeding, and Fibrosis-4 index were independent risk factors. A new model incorporating the Fibrosis-4 index and complications was developed, and discrimination was assessed using a bootstrap-corrected C statistic of 0.831. The area under the receiver operating characteristic curve of the new model (0.840, 95% confidence interval: 0.789 - 0.883) was significantly higher than that of the non-invasive scoring systems (all P < 0.05). The calibration plot and Hosmer-Lemeshow test (P = 0.771) showed good calibration accuracy. Kaplan-Meier survival analysis showed that the cumulative survival rate in the high-risk group was significantly lower (P < 0.01). Conclusions: The prognostic nomogram consisting of the Fibrosis-4 index and complications can effectively predict the risk of 3-month mortality in patients with hepatic encephalopathy. | en |
| DOI | https://doi.org/10.5812/hepatmon-134771 | en |
| URI | https://brieflands.com/journals/hepatmon/articles/134771 | en |
| Keyword | Hepatic Encephalopathy | en |
| Keyword | End Stage Liver Disease | en |
| Keyword | Complications | en |
| Keyword | Nomograms | en |
| Keyword | Survival Analysis | en |
| Publisher | Brieflands | en |
| Title | Development and Validation of a Prognostic Nomogram Based on Fibrosis-4 Index to Predict 3-Month Mortality in Patients with Hepatic Encephalopathy | en |
| Type | Research Article | en |