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列线图预测中国酒精性肝病患者的生存情况。

Nomogram to Predict the Survival of Chinese Patients with Alcohol-Related Liver Disease.

机构信息

Division 3, Department of Hepatology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

Division 2, Department of Hepatology, The Fourth People's Hospital of Qinghai Province, Xining, 810000, China.

出版信息

Can J Gastroenterol Hepatol. 2021 Sep 27;2021:4073503. doi: 10.1155/2021/4073503. eCollection 2021.

Abstract

OBJECTIVES

Alcohol-related liver disease is an increasing public health burden in China, but there is a lack of models to predict its prognosis. This study established a nomogram for predicting the survival of Chinese patients with alcohol-related liver disease (ALD).

METHODS

Hospitalized alcohol-related liver disease patients were retrospectively enrolled from 2015 to 2018 and followed up for 24 months to evaluate survival profiles. A total of 379 patients were divided into a training cohort ( = 265) and validation cohort ( = 114). Cox proportional hazard survival analysis identified survival factors of the patients in the training cohort. A nomogram was built and internally validated.

RESULTS

The 3-month, 6-month, 12-month, and 24-month survival rates for the training cohort were 82.6%, 81.1%, 74.3%, and 64.5%, respectively. The Cox analysis showed relapse (=0.001), cirrhosis (=0.044), liver cancer ( < 0.001), and a model for end-stage liver diseases score of ≥21 (=0.041) as independent prognostic factors. A nomogram was built, which predicted the survival of patients in the training cohort with a concordance index of 0.749 and in the internal validation cohort with a concordance index of 0.756.

CONCLUSION

The long-term survival of Chinese alcohol-related liver disease patients was poor with a 24-month survival rate of 64.5%. Relapse, cirrhosis, liver cancer, and a model for end-stage liver disease score of ≥21 were independent risk factors for those patients. A nomogram was developed and internally validated for predicting the probability of their survival at different time points.

摘要

目的

酒精性肝病在中国是一个日益严重的公共卫生负担,但缺乏预测其预后的模型。本研究建立了一个预测中国酒精性肝病(ALD)患者生存的列线图。

方法

回顾性纳入 2015 年至 2018 年住院的酒精性肝病患者,并随访 24 个月以评估生存情况。共纳入 379 例患者,分为训练队列(n=265)和验证队列(n=114)。Cox 比例风险生存分析确定了训练队列患者的生存因素。建立了一个列线图并进行内部验证。

结果

训练队列的 3 个月、6 个月、12 个月和 24 个月的生存率分别为 82.6%、81.1%、74.3%和 64.5%。Cox 分析显示,复发(=0.001)、肝硬化(=0.044)、肝癌(<0.001)和终末期肝病模型评分≥21(=0.041)是独立的预后因素。建立了一个列线图,该图预测了训练队列患者的生存情况,其一致性指数为 0.749,内部验证队列的一致性指数为 0.756。

结论

中国酒精性肝病患者的长期生存率较差,24 个月生存率为 64.5%。复发、肝硬化、肝癌和终末期肝病模型评分≥21 是这些患者的独立危险因素。开发了一个列线图并进行了内部验证,以预测不同时间点的生存概率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc40/8490064/ce622dee4990/CJGH2021-4073503.001.jpg

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