干旱区生态环境知识资源中心(Arid): A New Scoring System for Predicting In-hospital Death in Patients Having Liver Cirrhosis With Esophageal Varices

Arid

DOI	10.3389/fmed.2021.678646
	A New Scoring System for Predicting In-hospital Death in Patients Having Liver Cirrhosis With Esophageal Varices
	Xu, Fengshuo; Zhang, Luming; Wang, Zichen; Han, Didi; Li, Chengzhuo; Zheng, Shuai; Yin, Haiyan; Lyu, Jun
通讯作者	Lyu, J (corresponding author), Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China. ; Lyu, J (corresponding author), Xi An Jiao Tong Univ, Hlth Sci Ctr, Sch Publ Hlth, Xian, Peoples R China. ; Yin, HY (corresponding author), Jinan Univ, Affiliated Hosp 1, Intens Care Unit, Guangzhou, Peoples R China.
来源期刊	FRONTIERS IN MEDICINE
EISSN	2296-858X
出版年	2021
卷号	8
英文摘要	Introduction: Liver cirrhosis is caused by the development of various acute and chronic liver diseases. Esophageal varices is a common and serious complication of liver cirrhosis during decompensation. Despite the development of various treatments, the prognosis for liver cirrhosis with esophageal varices (LCEV) remains poor. We aimed to establish and validate a nomogram for predicting in-hospital death in LCEV patients.Methods: Data on LCEV patients were extracted from the Medical Information Mart for Intensive Care III and IV (MIMIC-III and MIMIC-IV) database. The patients from MIMIC-III were randomly divided into training and validation cohorts. Training cohort was used for establishing the model, validation and MIMIC-IV cohorts were used for validation. The independent prognostic factors for LCEV patients were determined using the least absolute shrinkage and selection operator (LASSO) method and forward stepwise logistic regression. We then constructed a nomogram to predict the in-hospital death of LCEV patients. Multiple indicators were used to validate the nomogram, including the area under the receiver operating characteristic curve (AUC), calibration curve, Hosmer-Lemeshow test, integrated discrimination improvement (IDI), net reclassification index (NRI), and decision curve analysis (DCA).Results: Nine independent prognostic factors were identified by using LASSO and stepwise regressions: age, Elixhauser score, anion gap, sodium, albumin, bilirubin, international normalized ratio, vasopressor use, and bleeding. The nomogram was then constructed and validated. The AUC value of the nomogram was 0.867 (95% CI = 0.832-0.904) in the training cohort, 0.846 (95% CI = 0.790-0.896) in the validation cohort and 0.840 (95% CI = 0.807-0.872) in the MIMIC-IV cohort. High AUC values indicated the good discriminative ability of the nomogram, while the calibration curves and the Hosmer-Lemeshow test results demonstrated that the nomogram was well-calibrated. Improvements in NRI and IDI values suggested that our nomogram was superior to MELD-Na, CAGIB, and OASIS scoring system. DCA curves indicated that the nomogram had good value in clinical applications.Conclusion: We have established the first prognostic nomogram for predicting the in-hospital death of LCEV patients. The nomogram is easy to use, performs well, and can be used to guide clinical practice, but further external prospective validation is still required.
英文关键词	liver cirrhotic with esophageal varices MIMIC nomogram prognosis in-hospital death
类型	Article
语种	英语
开放获取类型	Green Published, gold
收录类别	SCI-E
WOS记录号	WOS:000726164300001
WOS关键词	OUTCOMES
WOS类目	Medicine, General & Internal
WOS研究方向	General & Internal Medicine
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/373667
作者单位	[Xu, Fengshuo; Han, Didi; Li, Chengzhuo; Zheng, Shuai; Lyu, Jun] Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China; [Xu, Fengshuo; Han, Didi; Li, Chengzhuo; Lyu, Jun] Xi An Jiao Tong Univ, Hlth Sci Ctr, Sch Publ Hlth, Xian, Peoples R China; [Zhang, Luming; Yin, Haiyan] Jinan Univ, Affiliated Hosp 1, Intens Care Unit, Guangzhou, Peoples R China; [Wang, Zichen] Univ Calif Irvine, Dept Publ Hlth, Irvine, CA USA; [Zheng, Shuai] Shaanxi Univ Chinese Med, Sch Publ Hlth, Xianyang, Peoples R China
推荐引用方式 GB/T 7714	Xu, Fengshuo,Zhang, Luming,Wang, Zichen,et al. A New Scoring System for Predicting In-hospital Death in Patients Having Liver Cirrhosis With Esophageal Varices[J],2021,8.
APA	Xu, Fengshuo.,Zhang, Luming.,Wang, Zichen.,Han, Didi.,Li, Chengzhuo.,...&Lyu, Jun.(2021).A New Scoring System for Predicting In-hospital Death in Patients Having Liver Cirrhosis With Esophageal Varices.FRONTIERS IN MEDICINE,8.
MLA	Xu, Fengshuo,et al."A New Scoring System for Predicting In-hospital Death in Patients Having Liver Cirrhosis With Esophageal Varices".FRONTIERS IN MEDICINE 8(2021).