Prognostic Nomograms for Hospital Survival and Transplant-Free Survival of Patients with Hepatorenal Syndrome: A Retrospective Cohort Study.
Prognostic Nomograms for Hospital Survival and Transplant-Free Survival of Patients with Hepatorenal Syndrome: A Retrospective Cohort Study.
复制标题
DOI：
10.3390/diagnostics12061417
复制
发表时间：
2022-06-08
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
肝肾综合征（HRS）是肝硬化的一种危及生命的并发症，预后不良。为了开发新的和有效的列线图，可以在数字上预测HRS的住院生存率和无移植生存率，我们回顾性地招募了一组149例患者。采用基于最小Akaike信息标准值的后向逐步方法选择纳入考克斯比例风险模型的协变量。使用Harrell C指数、受试者工作特征曲线下面积（AUC）、Brier评分和Kaplan-Meier曲线以及对数秩检验评估列线图。采用1000个重新采样的自举方法进行内部验证。预测住院生存率的列线图包括凝血酶原活动度、HRS临床模式、Child-Pugh分级和基线血清肌酐。C指数为0.72（95%置信区间（CI），0.65 - 0.78），调整后的C指数为0.72（95% CI，0.66 - 0.79）。预测无移植存活率的诺模图包括性别、凝血酶原活动度、HRS临床模式、终末期肝病模型-Na评分和血清肌酐峰值。诺模图的C指数为0.74（95%CI，0.69 - 0.79），调整后的C指数为0.74（95%CI，0.68 - 0.79）。根据医院生存列线图计算的第15、30和45天的AUC和Brier评分以及根据无移植生存列线图计算的第6、12和18个月的AUC和Brier评分显示出良好的预测能力。这两个模型可用于识别HRS高危患者，促进早期干预治疗。
Hepatorenal syndrome (HRS) is a life-threatening complication of cirrhosis with a poor prognosis. To develop novel and effective nomograms which could numerically predict both the hospital survival and transplant-free survival of HRS, we retrospectively enrolled a cohort of 149 patients. A backward stepwise method based on the smallest Akaike information criterion value was applied to select the covariates to be included in the Cox proportional hazards models. The Harrell C-index, area under the receiver operating characteristic curve (AUC), Brier score, and Kaplan–Meier curves with the log-rank test were used to assess nomograms. The bootstrapping method with 1000 resamples was performed for internal validation. The nomogram predicting hospital survival included prothrombin activity, HRS clinical pattern, Child–Pugh class, and baseline serum creatinine. The C-index was 0.72 (95% confidence interval (CI), 0.65–0.78), and the adjusted C-index was 0.72 (95% CI, 0.66–0.79). The nomogram predicting transplant-free survival included sex, prothrombin activity, HRS clinical pattern, model for end-stage liver disease–Na score, and peak serum creatinine. The C-index of the nomogram was 0.74 (95% CI, 0.69–0.79), and the adjusted C-index was 0.74 (95% CI, 0.68–0.79). The AUC and Brier score at 15, 30, and 45 days calculated from the hospital survival nomogram and those at 6, 12, and 18 months calculated from the transplant-free survival nomogram revealed good predictive ability. The two models can be used to identify patients at high risk of HRS and promote early intervention treatment.
登录
查看更多内容
影响因子：
3.7
作者：
Rey R M;Delgado AF;De Zubiria A;Pinto R;De la Hoz-Valle JA;Pérez-Riveros ED;Ardila G;Sierra-Arango F
通讯作者：
Sierra-Arango F
影响因子：
12.6
作者：
Huelin, Patricia;Piano, Salvatore;Gines, Pere
通讯作者：
Gines, Pere
影响因子：
24.5
作者：
Tsien, Cynthia D.;Rabie, Rania;Wong, Florence
通讯作者：
Wong, Florence
影响因子：
6.7
作者：
Mauro, Ezequiel;Garcia-Olveira, Lucrecia;Gadano, Adrian
通讯作者：
Gadano, Adrian
影响因子：
25.7
作者：
Salerno, Francesco;Cazzaniga, Massimo;Angeli, Paolo
通讯作者：
Angeli, Paolo