Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 12 / 09 / 2021

Articles

Abstract

ORIGINAL ARTICLE

Development and Validation of a Prognostic Model for One-year Survival of Cirrhosis Patients with First-ever Spontaneous Bacterial Peritonitis

Rui-Rui Wang1,2,# , Hong-Qiu Gu3,4,# , Ying-Ying Wei5, Jin-Xiang Yang6, Yi-Xin Hou1 , Hui-Min Liu1 , Zhi-Yun Yang1 , Xian-Bo Wang1 and Yu-Yong Jiang1,*

1  Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
2  Graduate School, Beijing University of Chinese Medicine, Beijing, China
3  China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
4  National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
5  The first Clinical School, Beijing University of Chinese Medicine, Beijing, China
6  Department of Gastroenterology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
#These authors contributed equally to this study.
*Correspondence to:Yu-Yong Jiang, Beijing Diantan Hospital, Capital Medical University, Beijing 100015, China. ORCID: https://orcid.org/0000-0002-6082-1180. Tel: +86-13552175162, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(5):647-654 DOI: 10.14218/JCTH.2021.00031
Received:January 17, 2021 Accepted:April 27, 2021 Published online:May 24, 2021

Abstract

Background and Aims:Spontaneous bacterial peritonitis (SBP) is one of the leading causes of death in patients with liver cirrhosis. We aimed to establish a prognostic model to evaluate the 1-year survival of cirrhosis patients after the first episode of SBP.

Methods:A prognostic model was developed based on a retrospective derivation cohort of 309 cirrhosis patients with first-ever SBP and was validated in a separate validation cohort of 141 patients. We used Uno’s concordance, calibration curve, and decision curve (DCA) analysis to evaluate the discrimination, calibration, and clinical net benefit of the model.

Results:A total of 59 (19.1%) patients in the derivation cohort and 42 (29.8%) patients in the validation cohort died over the course of 1 year. A prognostic model in nomogram form was developed with predictors including age [hazard ratio (HR): 1.25; 95% confidence interval (CI): 0.92–1.71], total serum bilirubin (HR: 1.66; 95% CI: 1.28–2.14), serum sodium (HR: 0.94; 95% CI: 0.90–0.98), history of hypertension (HR: 2.52; 95% CI: 1.44–4.41) and hepatic encephalopathy (HR: 2.06; 95% CI: 1.13–3.73). The nomogram had a higher concordance (0.79) compared with the model end-stage liver disease (0.67) or Child-Turcotte-Pugh (0.71) score. The nomogram also showed acceptable calibration (calibration slope, 1.12; Bier score, 0.15±0.21) and optimal clinical net benefit in the validation cohort.

Conclusions:This prediction model developed based on characteristics of first-ever SBP patients may benefit the prediction of patients’ 1-year survival.

Keywords

Spontaneous bacterial peritonitis, Liver cirrhosis, Bacterial infection, Nomogram, Prognostic model, Predictors, Long-term outcome.

Journal of Clinical and Translational Hepatology 2021 vol. 9, 647-654  [ Html  ] [ PDF Full-text ]

© 2021 Authors. This is an Open Access article distributed under the terms of the  Creative Commons Attribution-Noncommercial 4.0 License(CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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