Dig Liver Dis. 2019 Jan 14. pii: S1590-8658(19)30011-8. doi: 10.1016/j.dld.2019.01.004. [Epub ahead of print]
A new algorithm for predicting long-term survival in chronic hepatitis B patients with variceal bleeding after endoscopic therapy.
He L1, Li P1, Jiang Y1, Hu J1, Ma J1, Ye X1, Yang J1, Zhou Y1, Liang X1, Ai Z1, Lin Y1, Wei H2.
Author information
1
Department of gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
2
Department of gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China. Electronic address: [email protected].
Abstract
BACKGROUND AND AIMS:
A predictive algorithm for survival is urgently needed in clinical practice. This study aimed to establish an algorithm to predict long-term survival in chronic hepatitis B (CHB) patients with hepatic cirrhosis and variceal bleeding after endoscopic therapy.
METHODS:
This was a retrospective study in which 603 patients who followed-up for three years were randomly assigned into a training cohort and a validation cohort in a 2:1 ratio. A new score model was devised based on the result of Cox regression analysis in the training cohort, and was verified in the validation cohort.
RESULTS:
A prediction score model composed of age, neutrophil-lymphocyte ratio, gamma-glutamyl transpeptidase and MELD score was established. The score ranged from 0 to 11. Areas under the ROC curve of the score were 0.821 (p < 0.001, 95% CI: 0.769-0.873) and 0.827 (p < 0.001, 95% CI: 0.753-0.900) in the training cohort and validation cohort, respectively. Scores 0-4 and 5-11 identified patients as low-risk and high-risk categories, respectively. The cumulative 3-year survival rate was significantly higher in the low-risk group than in the high-risk group (p < 0.001).
CONCLUSION:
The new score model can be used to predict long-term survival in CHB patients with hepatic cirrhosis and variceal bleeding after endoscopic therapy.