title: A model to determine 3-month mortality risk in patients with acute-on-chronic hepatitis B liver failure.
abstract: OBJECTIVE
  Liver failure has high mortality. There are accurate but controversial models to determine mortality of patients with acute-on-chronic hepatitis B liver failure (ACHBLF). We developed a logistic regression model (LRM) and tested its ability to predict the 3-month mortality of patients with ACHBLF.
  
  
  METHODS
  The LRM was constructed using data from an internal cohort of 242 consecutive patients with ACHBLF and was tested on an external cohort of 210 patients with the same conditions. The receiver operating characteristic curves were calculated for the LRM, model of end-stage liver disease (MELD), Child-Pugh score (CPS), and a previously reported LRM that has not yet been validated in patients with ACHBLF. Predictions of 3-month mortality obtained with 4 models from the same datasets were compared using areas under receiver operating characteristic curves.
  
  
  RESULTS
  The LRM identified 5 independent factors associated with survival of patients with ACHBLF: hepatic encephalopathy (odds ratio [OR], 2.165; 95% confidence interval [CI], 1.015-4.616), hepatorenal syndrome (OR, 9.767; 95% CI, 4.273-22.328), cirrhosis (OR, 2.339; 95% CI, 1.110-4.930), hepatitis B e antigen (OR, 2.874; 95% CI, 1.376-6.003), and prothrombin activity/age (OR, 0.12; 95% CI, 0.037-0.395). Data from the internal and external cohorts indicated that the LRM had significantly greater prognostic accuracy than the MELD, CPS, or previous LRM.
  
  
  CONCLUSIONS
  We developed a logistic regression model that predicted the 3-month mortality of patients with ACHBLF with greater accuracy than the MELD, CPS, or the previous LRM.
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China. blueman1320@163.com
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Zheng
authors.forename: Ke-Qing
authors.initials: KQ
authors.lastname: Shi
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Fan
authors.forename: Hai
authors.initials: H
authors.lastname: Li
authors.forename: Chao
authors.initials: C
authors.lastname: Ye
authors.forename: Qiong-Qiu
authors.initials: QQ
authors.lastname: Chen
authors.forename: Yong-Ping
authors.initials: YP
authors.lastname: Chen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D017093:Liver Failure / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment