Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol

Abstract This study aimed to identify predictive factors for the prognosis of acute-on-chronic liver disease (AoCLD) due to both hepatitis B virus (HBV) and alcohol and to develop prognostic models to improve treatment management. AoCLD patients with HBV and alcohol as etiological factors were selec...

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Main Authors: Hongqin Xu, Hai Li, Wenting Tan, Xianbo Wang, Xin Zheng, Yan Huang, Jinjun Chen, Zhongji Meng, Zhiping Qian, Feng Liu, Xiaobo Lu, Yu Shi, Yubao Zheng, Huadong Yan, Weituo Zhang, Xiaoyu Wen, Tao Liu, Yue Feng, Liang Qiao, Wenyi Gu, Yan Zhang, Guohong Deng, Yi Zhou, Shuning Sun, Yixin Hou, Qun Zhang, Yan Xiong, Jing Liu, Ruochan Chen, Min Zhang, Beiling Li, Xiuhua Jiang, Guotao Zhong, Haiyu Wang, Yuanyuan Chen, Sen Luo, Jing Li, Tao Li, Rongjiong Zheng, Xinyi Zhou, Haotang Ren, Yanhang Gao
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Language:English
Published: Nature Portfolio 2024-10-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-76473-z
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author Hongqin Xu
Hai Li
Wenting Tan
Xianbo Wang
Xin Zheng
Yan Huang
Jinjun Chen
Zhongji Meng
Zhiping Qian
Feng Liu
Xiaobo Lu
Yu Shi
Yubao Zheng
Huadong Yan
Weituo Zhang
Xiaoyu Wen
Tao Liu
Yue Feng
Liang Qiao
Wenyi Gu
Yan Zhang
Guohong Deng
Yi Zhou
Shuning Sun
Yixin Hou
Qun Zhang
Yan Xiong
Jing Liu
Ruochan Chen
Min Zhang
Beiling Li
Xiuhua Jiang
Guotao Zhong
Haiyu Wang
Yuanyuan Chen
Sen Luo
Jing Li
Tao Li
Rongjiong Zheng
Xinyi Zhou
Haotang Ren
Yanhang Gao
author_facet Hongqin Xu
Hai Li
Wenting Tan
Xianbo Wang
Xin Zheng
Yan Huang
Jinjun Chen
Zhongji Meng
Zhiping Qian
Feng Liu
Xiaobo Lu
Yu Shi
Yubao Zheng
Huadong Yan
Weituo Zhang
Xiaoyu Wen
Tao Liu
Yue Feng
Liang Qiao
Wenyi Gu
Yan Zhang
Guohong Deng
Yi Zhou
Shuning Sun
Yixin Hou
Qun Zhang
Yan Xiong
Jing Liu
Ruochan Chen
Min Zhang
Beiling Li
Xiuhua Jiang
Guotao Zhong
Haiyu Wang
Yuanyuan Chen
Sen Luo
Jing Li
Tao Li
Rongjiong Zheng
Xinyi Zhou
Haotang Ren
Yanhang Gao
author_sort Hongqin Xu
collection DOAJ
description Abstract This study aimed to identify predictive factors for the prognosis of acute-on-chronic liver disease (AoCLD) due to both hepatitis B virus (HBV) and alcohol and to develop prognostic models to improve treatment management. AoCLD patients with HBV and alcohol as etiological factors were selected from two multicenter prospective cohorts (NCT02457637,NCT03641872) and included in separate training and validation cohorts (n = 180 and n = 148). In the training cohort, the CATCH-LIFE A nomogram (based on age, bilirubin, international normalized ratio, serum sodium, and hepatic encephalopathy score) and CATCH-LIFE B nomogram (based on age, bilirubin, international normalized ratio, serum albumin, white blood cell, platelet count, and hepatic encephalopathy score) had discriminatory ability for predicting 28-day (c-indexes of 0.910 and 0.899) and 90-day mortality (c-indexes of 0.878 and 0.887, respectively). The area under the curve values for 28-day and 90-day mortality prediction by the CATCH-LIFE A nomogram were 0.922 (95% CI : 0.874, 0.971) and 0.905 (0.856, 0.956), respectively, while those for the CATCH-LIFE B nomogram were 0.916(0.861,0.972) and 0.915 (0.866,0.964), respectively. Similar performance results were observed in the validation cohort. Optimal cut-off scores for each nomogram could be used for patient stratification in high- and low-risk groups, and the high-risk groups showed shorter survival times than the low-risk groups in both the training and validation cohorts. Two nomograms constructed from the first short-term follow-up data from patients with AoCLD due to combined HBV infection and alcohol exposure showed good predictive performance for 28-day and 90-day mortality and might be used to guide clinical management.
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spelling doaj-art-e36fb3ffc3974c80acfb09a845a5efce2025-08-20T02:17:45ZengNature PortfolioScientific Reports2045-23222024-10-0114111310.1038/s41598-024-76473-zNomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcoholHongqin Xu0Hai Li1Wenting Tan2Xianbo Wang3Xin Zheng4Yan Huang5Jinjun Chen6Zhongji Meng7Zhiping Qian8Feng Liu9Xiaobo Lu10Yu Shi11Yubao Zheng12Huadong Yan13Weituo Zhang14Xiaoyu Wen15Tao Liu16Yue Feng17Liang Qiao18Wenyi Gu19Yan Zhang20Guohong Deng21Yi Zhou22Shuning Sun23Yixin Hou24Qun Zhang25Yan Xiong26Jing Liu27Ruochan Chen28Min Zhang29Beiling Li30Xiuhua Jiang31Guotao Zhong32Haiyu Wang33Yuanyuan Chen34Sen Luo35Jing Li36Tao Li37Rongjiong Zheng38Xinyi Zhou39Haotang Ren40Yanhang Gao41Department of Hepatology, The First Hospital of Jilin University, Jilin UniversityDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University)Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical UniversityDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South UniversityHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical UniversityDepartment of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of MedicineDepartment of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Fudan UniversityDepartment of Infectious Diseases and Hepatology, The Second Hospital of Shandong UniversityInfectious Disease Center, First Affiliated Hospital of Xinjiang Medical UniversityThe State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of School of Medicine, Zhejiang UniversityDepartment of Infectious Diseases, Third Affiliated Hospital, Sun Yat-sen UniversityInfectious Disease Department, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeClinical Research Institute, Shanghai Jiao Tong University School of MedicineDepartment of Hepatology, The First Hospital of Jilin University, Jilin UniversityDepartment of Hepatology, The First Hospital of Jilin University, Jilin UniversityDepartment of Hepatology, The First Hospital of Jilin University, Jilin UniversityDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University)Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical UniversityCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical UniversityDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South UniversityDepartment of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South UniversityHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical UniversityHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical UniversityHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical UniversityHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical UniversityDepartment of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of MedicineDepartment of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of MedicineDepartment of Infectious Diseases and Hepatology, The Second Hospital of Shandong UniversityDepartment of Infectious Diseases and Hepatology, The Second Hospital of Shandong UniversityInfectious Disease Center, First Affiliated Hospital of Xinjiang Medical UniversityInfectious Disease Center, First Affiliated Hospital of Xinjiang Medical UniversityThe State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of School of Medicine, Zhejiang UniversityDepartment of Hepatology, The First Hospital of Jilin University, Jilin UniversityAbstract This study aimed to identify predictive factors for the prognosis of acute-on-chronic liver disease (AoCLD) due to both hepatitis B virus (HBV) and alcohol and to develop prognostic models to improve treatment management. AoCLD patients with HBV and alcohol as etiological factors were selected from two multicenter prospective cohorts (NCT02457637,NCT03641872) and included in separate training and validation cohorts (n = 180 and n = 148). In the training cohort, the CATCH-LIFE A nomogram (based on age, bilirubin, international normalized ratio, serum sodium, and hepatic encephalopathy score) and CATCH-LIFE B nomogram (based on age, bilirubin, international normalized ratio, serum albumin, white blood cell, platelet count, and hepatic encephalopathy score) had discriminatory ability for predicting 28-day (c-indexes of 0.910 and 0.899) and 90-day mortality (c-indexes of 0.878 and 0.887, respectively). The area under the curve values for 28-day and 90-day mortality prediction by the CATCH-LIFE A nomogram were 0.922 (95% CI : 0.874, 0.971) and 0.905 (0.856, 0.956), respectively, while those for the CATCH-LIFE B nomogram were 0.916(0.861,0.972) and 0.915 (0.866,0.964), respectively. Similar performance results were observed in the validation cohort. Optimal cut-off scores for each nomogram could be used for patient stratification in high- and low-risk groups, and the high-risk groups showed shorter survival times than the low-risk groups in both the training and validation cohorts. Two nomograms constructed from the first short-term follow-up data from patients with AoCLD due to combined HBV infection and alcohol exposure showed good predictive performance for 28-day and 90-day mortality and might be used to guide clinical management.https://doi.org/10.1038/s41598-024-76473-zHBV infectionAlcohol-related liver diseaseNomogramProspective cohortTransplant free survival
spellingShingle Hongqin Xu
Hai Li
Wenting Tan
Xianbo Wang
Xin Zheng
Yan Huang
Jinjun Chen
Zhongji Meng
Zhiping Qian
Feng Liu
Xiaobo Lu
Yu Shi
Yubao Zheng
Huadong Yan
Weituo Zhang
Xiaoyu Wen
Tao Liu
Yue Feng
Liang Qiao
Wenyi Gu
Yan Zhang
Guohong Deng
Yi Zhou
Shuning Sun
Yixin Hou
Qun Zhang
Yan Xiong
Jing Liu
Ruochan Chen
Min Zhang
Beiling Li
Xiuhua Jiang
Guotao Zhong
Haiyu Wang
Yuanyuan Chen
Sen Luo
Jing Li
Tao Li
Rongjiong Zheng
Xinyi Zhou
Haotang Ren
Yanhang Gao
Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol
Scientific Reports
HBV infection
Alcohol-related liver disease
Nomogram
Prospective cohort
Transplant free survival
title Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol
title_full Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol
title_fullStr Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol
title_full_unstemmed Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol
title_short Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol
title_sort nomograms for predicting short term mortality in acute on chronic liver disease caused by the combination of hepatitis b virus and alcohol
topic HBV infection
Alcohol-related liver disease
Nomogram
Prospective cohort
Transplant free survival
url https://doi.org/10.1038/s41598-024-76473-z
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