Revue: | Annals of hepatology |
Base de datos: | PERIÓDICA |
Número de sistema: | 000409085 |
ISSN: | 1665-2681 |
Autores: | Shen,Yi1 Liu, Yan-Mei1 Wang, Bin2 Zhu, Yong-Gen2 Wang, Yuan-Yuan1 Qin, Gang2 Wang, Xu-Lin1 Ji, Ju-Ling3 Shao, Jian-Guo2 Qin, Yan4 |
Instituciones: | 1Nantong University, School of Public Health, Nantong. China 2Nantong University, Nantong Third People’s Hospital, Nantong. China 3Nantong University, Medical School, Nantong. China 4Singapore General Hospital, Department of Internal Medicne, Singapur. Singapur |
Año: | 2016 |
Volumen: | 15 |
Número: | 2 |
Paginación: | 236-245 |
País: | México |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Aplicado, descriptivo |
Resumen en inglés | Acute-on-chronic liver failure has high mortality. Currently, robust models for predicting the outcome of hepatitis B virus (HBV)-associated ACLF are lacking. To assess and compare the performance of six prevalent models for short- and longterm prognosis in patients with HBV-ACLF. The model for end-stage liver disease (MELD), MELD sodium (MELD-Na), MELD to sodium ratio (MESO), integrated MELD, Child-Turcotte-Pugh (CTP), and modified CTP (mCTP) were validated 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. 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. Integrated MELD may be the best model to predict short- and long-term prognosis in patients with HBV-ACLF |
Disciplinas: | Medicina |
Palabras clave: | Gastroenterología, Virus de la hepatitis B, Falla hepática, Falla hepática aguda, Prognosis |
Keyword: | Medicine, Gastroenterology, Hepatitis B virus, Liver failure, Acute liver failure, Prognosis |
Texte intégral: | Texto completo (Ver PDF) |