Construction of a risk prediction model for overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension

Lanjing WANG; Jianping QIN; Xin YAO; Qi QI; Lin LIU; Shanhong TANG

doi:10.12449/JCH240613

Volume 40 Issue 6

Jun. 2024

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Article Navigation > Journal of Clinical Hepatology > 2024 > 40(6): 1149-1155

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Construction of a risk prediction model for overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension

DOI: 10.12449/JCH240613

Lanjing WANG^{1, 2},
Jianping QIN²,
Xin YAO²,
Qi QI²,
Lin LIU²,
Shanhong TANG^{1, 2
,
,
,}

1.
Department of Gastroenterology，The Affiliated Hospital of Southwest Medical University，Luzhou，Sichuan 646099，China
2.
Department of Gastroenterology，The General Hospital of Western Theater Command，Chengdu 610083，China

Research funding:

Project of Sichuan Provincial Administration of Traditional Chinese Medicine (2023MS458)

More Information

Corresponding author: TANG Shanhong， tangshanhong@swjtu.edu.cn （ORCID： 0000-0001-6652-2942）
Received Date: 2023-09-01
Accepted Date: 2023-09-19
Published Date: 2024-06-25

Abstract

Abstract

Objective To investigate the influencing factors for overt hepatic encephalopathy （OHE） in patients with hepatitis B cirrhosis after transjugular intrahepatic portosystemic shunt （TIPS）， and to construct an individualized risk prediction model. Methods A total of 302 patients with hepatitis B cirrhosis who underwent TIPS in Department of Gastroenterology， The General Hospital of Western Theater Command， from January 2017 to December 2021 were enrolled， and according to the presence or absence of OHE after surgery， they were divided into non-OHE group with 237 patients and OHE group with 65 patients. The two groups were compared in terms of general data， laboratory markers， Child-Turcotte-Pugh （CTP） score， MELD combined with serum sodium concentration （MELD-Na） score， and albumin-bilirubin （ALBI） score before surgery. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate logistic regression analyses were used to identify the influencing factors for OHE after TIPS in patients with hepatitis B cirrhosis， and independent influencing factors were used to construct a nomogram model. The receiver operating characteristic （ROC） curve analysis and the calibration curve analysis were used to evaluate the discriminatory ability and calibration of the model， and the decision curve analysis and the clinical impact curve （CIC） were used to evaluate the clinical effectiveness of the model. Results Age （odds ratio ［OR］=1.035， 95% confidence interval ［CI］： 1.004‍ ‍—‍ ‍1.066， P<0.05）， white blood cell count （WBC）/platelet count （PLT） ratio （OR=33.725， 95%CI： 1.220‍ ‍—‍ ‍932.377， P<0.05）， international normalized ratio （INR）（OR=5.149， 95%CI： 1.052‍ ‍—‍ ‍25.207， P<0.05）， and pre-albumin （PAB）（OR=0.992， 95%CI： 0.983‍ ‍—‍ ‍1.000， P<0.05） were independent predictive factors for OHE after TIPS in patients with hepatitis B cirrhosis. The nomogram model constructed based on age， WBC/PLT ratio， INR， and PAB had an area under the ROC curve of 0.716 （95%CI： 0.649‍ ‍—‍ ‍0.781）， with a sensitivity of 78.5% and a specificity of 56.1%. Conclusion The nomogram model constructed based on age， WBC/PLT ratio， INR， and PAB can help to predict the risk of OHE after TIPS in patients with hepatitis B cirrhosis.
- Liver Cirrhosis,
- Hypertension， Portal,
- Portasystemic Shunt， Transjugular Intrahepatic,
- Hepatic Encephalopathy,
- Nomograms

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References(21)

References

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Construction of a risk prediction model for overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension

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Construction of a risk prediction model for overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension

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