PMID- 37770848
OWN - NLM
STAT- MEDLINE
DCOM- 20231002
LR  - 20231123
IS  - 1471-230X (Electronic)
IS  - 1471-230X (Linking)
VI  - 23
IP  - 1
DP  - 2023 Sep 28
TI  - Establishment and validation of a prognosis nomogram for MIMIC-III patients with 
      liver cirrhosis complicated with hepatic encephalopathy.
PG  - 335
LID - 10.1186/s12876-023-02967-1 [doi]
LID - 335
AB  - INTRODUCE: The purpose of this study was to establish a comprehensive prognosis 
      nomogram for patients with liver cirrhosis complicated with hepatic 
      encephalopathy (HE) in the intensive care unit (ICU) and to evaluate the 
      predictive value of the nomogram. METHOD: This study analyzed 620 patients with 
      liver cirrhosis complicated with HE from the Medical Information Mart for 
      Intensive Care III(MIMIC-III) database. The patients were randomly divided into 
      two groups in a 7-to-3 ratio to form a training cohort (n = 434) and a validation 
      cohort (n = 176). Cox regression analyses were used to identify associated risk 
      variables. Based on the multivariate Cox regression model results, a nomogram was 
      established using associated risk predictor variables to predict the 90-day 
      survival rate of patients with cirrhosis complicated with HE. The new model was 
      compared with the Sequential organ failure assessment (SOFA) scoring model in 
      terms of the concordance index (C-index), the area under the curve (AUC) of 
      receiver operating characteristic (ROC) analysis, the net reclassification 
      improvement (NRI), the integrated discrimination improvement (IDI), calibration 
      curve, and decision curve analysis (DCA). RESULTS: This study showed that older 
      age, higher mean heart rate, lower mean arterial pressure, lower mean 
      temperature, higher SOFA score, higher RDW, and the use of albumin were risk 
      factors for the prognosis of patients with liver cirrhosis complicated with HE. 
      The use of proton pump inhibitors (PPI) was a protective factor. The performance 
      of the nomogram was evaluated using the C-index, AUC, IDI value, NRI value, and 
      DCA curve, showing that the nomogram was superior to that of the SOFA model 
      alone. Calibration curve results showed that the nomogram had excellent 
      calibration capability. The decision curve analysis confirmed the good clinical 
      application ability of the nomogram. CONCLUSION: This study is the first study of 
      the 90-day survival rate prediction of cirrhotic patients with HE in ICU through 
      the data of the MIMIC-III database. It is confirmed that the eight-factor 
      nomogram has good efficiency in predicting the 90-day survival rate of patients.
CI  - (c) 2023. BioMed Central Ltd., part of Springer Nature.
FAU - Yan, Wansheng
AU  - Yan W
AD  - Department of Gastroenterology, The First Affiliated Hospital of Jinan 
      University, Guangzhou, 510630, China.
FAU - Yao, Zhihui
AU  - Yao Z
AD  - Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen 
      University, Guangzhou, 510655, China.
FAU - Ou, Qiutong
AU  - Ou Q
AD  - Department of Gastroenterology, The First Affiliated Hospital of Jinan 
      University, Guangzhou, 510630, China.
FAU - Ye, Gang
AU  - Ye G
AUID- ORCID: 0000-0002-6196-6074
AD  - Department of Gastroenterology, The First Affiliated Hospital of Jinan 
      University, Guangzhou, 510630, China. dryegang@163.com.
LA  - eng
GR  - 2023A1515011617/Basic and Applied Basic Research Foundation of Guangdong 
      Province/
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20230928
PL  - England
TA  - BMC Gastroenterol
JT  - BMC gastroenterology
JID - 100968547
SB  - IM
MH  - Humans
MH  - *Nomograms
MH  - *Hepatic Encephalopathy/diagnosis/etiology
MH  - Prognosis
MH  - Liver Cirrhosis/complications
MH  - Risk Factors
PMC - PMC10538063
OTO - NOTNLM
OT  - Cirrhosis
OT  - Hepatic encephalopathy
OT  - MIMIC-III database
OT  - Nomogram
OT  - Prognosis
OT  - Sequential organ failure assessment score
COIS- All authors declare that there is no conflict of interest.
EDAT- 2023/09/29 00:42
MHDA- 2023/10/02 06:42
PMCR- 2023/09/28
CRDT- 2023/09/28 23:46
PHST- 2022/10/31 00:00 [received]
PHST- 2023/09/20 00:00 [accepted]
PHST- 2023/10/02 06:42 [medline]
PHST- 2023/09/29 00:42 [pubmed]
PHST- 2023/09/28 23:46 [entrez]
PHST- 2023/09/28 00:00 [pmc-release]
AID - 10.1186/s12876-023-02967-1 [pii]
AID - 2967 [pii]
AID - 10.1186/s12876-023-02967-1 [doi]
PST - epublish
SO  - BMC Gastroenterol. 2023 Sep 28;23(1):335. doi: 10.1186/s12876-023-02967-1.