1. Development and Validation of a Prognostic Model for One-year Survival of Cirrhosis Patients with First-ever Spontaneous Bacterial Peritonitis
- Author
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Yixin Hou, Hong-Qiu Gu, Xianbo Wang, Rui-Rui Wang, Jin-Xiang Yang, Ying-Ying Wei, Huimin Liu, Yuyong Jiang, and Zhiyun Yang
- Subjects
First episode ,medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,Predictors ,Nomogram ,medicine.disease ,Gastroenterology ,Spontaneous bacterial peritonitis ,Internal medicine ,Liver cirrhosis ,medicine ,Prognostic model ,In patient ,Original Article ,cardiovascular diseases ,Bacterial infection ,business ,circulatory and respiratory physiology ,Long-term outcome - 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.
- Published
- 2021