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肝硬化患者静脉曲张再出血预测模型的局限性与改进机会

Limitations and enhancement opportunities for variceal rebleeding prediction model in patients with cirrhosis.

作者信息

Chen Guang-Bin, Wu Fei, Tang Rong-Mei, Chen Long-Jiang

机构信息

Department of Hepatobiliary Surgery, The Second People's Hospital of Wuhu, Wuhu Hospital Affiliated to East China Normal University, Wuhu 241000, Anhui Province, China.

Graduate School, Wannan Medical College, Wuhu 241000, Anhui Province, China.

出版信息

World J Gastroenterol. 2025 Feb 28;31(8):102841. doi: 10.3748/wjg.v31.i8.102841.

Abstract

A multicenter study recently published introduced a novel prognostic model for predicting esophagogastric variceal rebleeding after endoscopic treatment in patients with cirrhosis. The model incorporated six readily available clinical variables-albumin level, aspartate aminotransferase level, white blood cell count, ascites, portal vein thrombosis, and bleeding signs-and demonstrated promising predictive performance. However, limitations, including the retrospective design and exclusion of patients with hepatocellular carcinoma, may affect the generalizability of the model. Additionally, further improvement is needed in the model's discrimination between intermediate- and high-risk groups in external. Prospective validation and inclusion of additional variables are recommended to enhance predictive accuracy across diverse clinical scenarios.

摘要

最近发表的一项多中心研究引入了一种新型预后模型,用于预测肝硬化患者内镜治疗后食管胃静脉曲张再出血。该模型纳入了六个易于获得的临床变量——白蛋白水平、天冬氨酸转氨酶水平、白细胞计数、腹水、门静脉血栓形成和出血迹象——并显示出有前景的预测性能。然而,包括回顾性设计和排除肝细胞癌患者等局限性,可能会影响该模型的通用性。此外,该模型在外部对中高危组的区分方面还需要进一步改进。建议进行前瞻性验证并纳入更多变量,以提高在不同临床场景下的预测准确性。

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