Accurate long-term prediction of death for patients with cirrhosis.
Accurate long-term prediction of death for patients with cirrhosis.
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DOI：
10.1002/hep.32457
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发表时间：
2022-09
期刊：
影响因子：
13.5
通讯作者：
Reese, Peter P.
中科院分区：
文献类型：
--
作者：
Goldberg, David;Mantero, Alejandro;Kaplan, David;Delgado, Cindy;John, Binu;Nuchovich, Nadine;Emanuel, Ezekiel;Reese, Peter P.
Cirrhosis is a major cause of death and is associated with extensive healthcare utilization. Patients with cirrhosis have complex treatment choices due to risks of morbidity and mortality. To optimally counsel and treat patients with cirrhosis requires tools to predict their longer-term liver-related survival. We sought to develop and validate a risk score to predict longer-term survival of patients with cirrhosis. Retrospective cohort study of adults with cirrhosis with no major life-limtiing co-morbidities. Adults with cirrhosis within the Veterans Health Administration were used for model training and internal validation, and external validation used the OneFlorida Clinical Research Consortium. We used four model-building approaches including variables predictive of cirrhosis-related mortality, focused on discrimination at key timepoints (1-, 3-, 5-, and 10-years). Among 30,263 patients with cirrhosis ≤75 years without major life-limiting co-morbidities and complete laboratory data during the baseline period, the boosted survival tree models had the highest discrimination, with 1-, 3-, 5-, and 10-year survival of 0.77, 0.81, 0.84, and 0.88, respectively. The 1-, 3-, and 5-year discrimination was nearly identical in external validation. Secondary analyses with imputation of missing data and subgroups by etiology of liver disease had similar results to the primary model. We developed and validated (internally and externally) a risk score to predict longer-term survival of patients with cirrhosis. This score would transform management of patients with cirrhosis in terms of referral to specialty care and treatment decision-making for non-liver related care.
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影响因子：
8.8
作者：
Goldberg, D. S.;French, B.;Halpern, S. D.
通讯作者：
Halpern, S. D.
DOI：
10.1002/hep.31558
发表时间：
2021-01
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Mahmud N;Fricker Z;Hubbard RA;Ioannou GN;Lewis JD;Taddei TH;Rothstein KD;Serper M;Goldberg DS;Kaplan DE
通讯作者：
Kaplan DE
影响因子：
19.6
作者：
Levey, AS;Eckardt, KU;Eknoyan, G
通讯作者：
Eknoyan, G
影响因子：
29.4
作者：
Jepsen, Peter;Vilstrup, Hendrik;Lash, Timothy L.
通讯作者：
Lash, Timothy L.
影响因子：
4
作者：
Jakobsen JC;Gluud C;Wetterslev J;Winkel P
通讯作者：
Winkel P