Description

Zheng et al developed a logistic regression model for predicting 3-month mortality for a patient with hepatitis B virus (HBV) causing acute-on-chronic liver failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from Wenzhou Medical College, Shandong University, Tianjin Infectious Disease Hospital and Wenzhou Third People's Hospital in China.


Patient selection: acute-on-chronic liver failure in a patient with chronic HBV infection

 

Outcome: 3-month mortality

 

Criteria for acute-on-chronic liver failure:

(1) chronic HBV infection

(2) jaundice

(3) coagulopathy

(4) ascites and/or encephalopathy within 4 weeks

 

Parameters:

(1) hepatic encephalopathy

(2) hepatorenal syndrome (HRS)

(3) cirrhosis

(4) HBeAg

(5) PTA to age ratio (PTA is prothrombin activity, in percent)

 

Parameter

Finding

Points

hepatic encephalopathy

absent

0

 

present

0.772

hepatorenal syndrome

absent

0

 

present

2.279

cirrhosis

absent

0

 

present

0.850

HBeAg

absent

0

 

present

1.056

PTA to age ratio

 

-2.117 * (ratio)

 

X =

= SUM(points for all 5 parameters) - 1.343

 

probability of 3-month mortality =

= 1 / (1 + EXP((-1) * X))

 

Performance:

• The area under the ROC curves is 0.84.


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