Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models

Early diagnosis and accurate prognostic evaluation are important for guiding clinical treatment and reducing mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). The present study established novel prognostic scoring models to guide the clinical treatment...

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Main Authors: Hongyan Guo, Fengling Fang, Lin Lin, Zhaopei Guo, Lu Lai, Yue Shi, Tianbin Chen, Ruimin Lai, Qishui Ou, Ya Fu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Virulence
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Online Access:https://www.tandfonline.com/doi/10.1080/21505594.2025.2500490
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author Hongyan Guo
Fengling Fang
Lin Lin
Zhaopei Guo
Lu Lai
Yue Shi
Tianbin Chen
Ruimin Lai
Qishui Ou
Ya Fu
author_facet Hongyan Guo
Fengling Fang
Lin Lin
Zhaopei Guo
Lu Lai
Yue Shi
Tianbin Chen
Ruimin Lai
Qishui Ou
Ya Fu
author_sort Hongyan Guo
collection DOAJ
description Early diagnosis and accurate prognostic evaluation are important for guiding clinical treatment and reducing mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). The present study established novel prognostic scoring models to guide the clinical treatment of patients with HBV-ACLF. We performed a retrospective analysis of clinical data from two cohorts of patients diagnosed with HBV-ACLF. By comparing differences in baseline characteristics and clinical indicators between the survival (n = 102) and dead (n = 64) groups in the derivation cohort(n = 166), four laboratory indicators (age, INR, TBIL, and HBeAg status) and three clinical signs (extrahepatic infection, ascites, and hepatic encephalopathy) were identified as independent risk factors. Logistic regression and nomogram models were used to construct three novel predictive models. By comparing the death and survival groups, we found that the three new models had higher predictions for AUROC (average of 0.856) than the three old models (average of 0.773). Model 1 had the strongest predictive power for the short-term survival rate of HBV-ACLF patients. Finally, we verified the predictive value of the new models for HBV-ACLF in a validation cohort (n = 42), and the Model 2 demonstrated good predictive accuracy for the 30-day survival rate of patients. The novel model based on seven predictors could accurately predict short-term mortality in patients with HBV-ACLF, which is promising for guiding clinical management and addressing the aetiological differences in Asian populations.
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spelling doaj-art-a72223e620304bae8f8f72d2358fff662025-08-20T02:31:43ZengTaylor & Francis GroupVirulence2150-55942150-56082025-12-0116110.1080/21505594.2025.2500490Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical modelsHongyan Guo0Fengling Fang1Lin Lin2Zhaopei Guo3Lu Lai4Yue Shi5Tianbin Chen6Ruimin Lai7Qishui Ou8Ya Fu9Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of the Center of Liver Diseases, The First Affiliated Hospital of Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaEarly diagnosis and accurate prognostic evaluation are important for guiding clinical treatment and reducing mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). The present study established novel prognostic scoring models to guide the clinical treatment of patients with HBV-ACLF. We performed a retrospective analysis of clinical data from two cohorts of patients diagnosed with HBV-ACLF. By comparing differences in baseline characteristics and clinical indicators between the survival (n = 102) and dead (n = 64) groups in the derivation cohort(n = 166), four laboratory indicators (age, INR, TBIL, and HBeAg status) and three clinical signs (extrahepatic infection, ascites, and hepatic encephalopathy) were identified as independent risk factors. Logistic regression and nomogram models were used to construct three novel predictive models. By comparing the death and survival groups, we found that the three new models had higher predictions for AUROC (average of 0.856) than the three old models (average of 0.773). Model 1 had the strongest predictive power for the short-term survival rate of HBV-ACLF patients. Finally, we verified the predictive value of the new models for HBV-ACLF in a validation cohort (n = 42), and the Model 2 demonstrated good predictive accuracy for the 30-day survival rate of patients. The novel model based on seven predictors could accurately predict short-term mortality in patients with HBV-ACLF, which is promising for guiding clinical management and addressing the aetiological differences in Asian populations.https://www.tandfonline.com/doi/10.1080/21505594.2025.2500490Risk predictionprognostic scoreshort-term mortalityclinical managementAsian populations
spellingShingle Hongyan Guo
Fengling Fang
Lin Lin
Zhaopei Guo
Lu Lai
Yue Shi
Tianbin Chen
Ruimin Lai
Qishui Ou
Ya Fu
Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models
Virulence
Risk prediction
prognostic score
short-term mortality
clinical management
Asian populations
title Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models
title_full Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models
title_fullStr Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models
title_full_unstemmed Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models
title_short Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models
title_sort novel prognostic scoring models for hepatitis b virus related acute on chronic liver failure a comparison with classical models
topic Risk prediction
prognostic score
short-term mortality
clinical management
Asian populations
url https://www.tandfonline.com/doi/10.1080/21505594.2025.2500490
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