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Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis
Artificial liver support systems (ALSS) are widely used to treat patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The aims of the present study were to investigate the subgroups of patients with HBV-ACLF who may benefit from ALSS therapy, and the relevant patient-sp...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848208/ https://www.ncbi.nlm.nih.gov/pubmed/31712684 http://dx.doi.org/10.1038/s41598-019-53029-0 |
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author | Huang, Kaizhou Ji, Feiyang Xie, Zhongyang Wu, Daxian Xu, Xiaowei Gao, Hainv Ouyang, Xiaoxi Xiao, Lanlan Zhou, Menghao Zhu, Danhua Li, Lanjuan |
author_facet | Huang, Kaizhou Ji, Feiyang Xie, Zhongyang Wu, Daxian Xu, Xiaowei Gao, Hainv Ouyang, Xiaoxi Xiao, Lanlan Zhou, Menghao Zhu, Danhua Li, Lanjuan |
author_sort | Huang, Kaizhou |
collection | PubMed |
description | Artificial liver support systems (ALSS) are widely used to treat patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The aims of the present study were to investigate the subgroups of patients with HBV-ACLF who may benefit from ALSS therapy, and the relevant patient-specific factors. 489 ALSS-treated HBV-ACLF patients were enrolled, and served as derivation and validation cohorts for classification and regression tree (CART) analysis. CART analysis identified three factors prognostic of survival: hepatic encephalopathy (HE), prothrombin time (PT), and total bilirubin (TBil) level; and two distinct risk groups: low (28-day mortality 10.2–39.5%) and high risk (63.8–91.1%). The CART model showed that patients lacking HE and with a PT ≤ 27.8 s and a TBil level ≤455 μmol/L experienced less 28-day mortality after ALSS therapy. For HBV-ACLF patients with HE and a PT > 27.8 s, mortality remained high after such therapy. Patients lacking HE with a PT ≤ 27.8 s and TBil level ≤ 455 μmol/L may benefit markedly from ALSS therapy. For HBV-ACLF patients at high risk, unnecessary ALSS therapy should be avoided. The CART model is a novel user-friendly tool for screening HBV-ACLF patient eligibility for ALSS therapy, and will aid clinicians via ACLF risk stratification and therapeutic guidance. |
format | Online Article Text |
id | pubmed-6848208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-68482082019-11-19 Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis Huang, Kaizhou Ji, Feiyang Xie, Zhongyang Wu, Daxian Xu, Xiaowei Gao, Hainv Ouyang, Xiaoxi Xiao, Lanlan Zhou, Menghao Zhu, Danhua Li, Lanjuan Sci Rep Article Artificial liver support systems (ALSS) are widely used to treat patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The aims of the present study were to investigate the subgroups of patients with HBV-ACLF who may benefit from ALSS therapy, and the relevant patient-specific factors. 489 ALSS-treated HBV-ACLF patients were enrolled, and served as derivation and validation cohorts for classification and regression tree (CART) analysis. CART analysis identified three factors prognostic of survival: hepatic encephalopathy (HE), prothrombin time (PT), and total bilirubin (TBil) level; and two distinct risk groups: low (28-day mortality 10.2–39.5%) and high risk (63.8–91.1%). The CART model showed that patients lacking HE and with a PT ≤ 27.8 s and a TBil level ≤455 μmol/L experienced less 28-day mortality after ALSS therapy. For HBV-ACLF patients with HE and a PT > 27.8 s, mortality remained high after such therapy. Patients lacking HE with a PT ≤ 27.8 s and TBil level ≤ 455 μmol/L may benefit markedly from ALSS therapy. For HBV-ACLF patients at high risk, unnecessary ALSS therapy should be avoided. The CART model is a novel user-friendly tool for screening HBV-ACLF patient eligibility for ALSS therapy, and will aid clinicians via ACLF risk stratification and therapeutic guidance. Nature Publishing Group UK 2019-11-11 /pmc/articles/PMC6848208/ /pubmed/31712684 http://dx.doi.org/10.1038/s41598-019-53029-0 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Huang, Kaizhou Ji, Feiyang Xie, Zhongyang Wu, Daxian Xu, Xiaowei Gao, Hainv Ouyang, Xiaoxi Xiao, Lanlan Zhou, Menghao Zhu, Danhua Li, Lanjuan Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis |
title | Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis |
title_full | Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis |
title_fullStr | Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis |
title_full_unstemmed | Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis |
title_short | Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis |
title_sort | artificial liver support system therapy in acute-on-chronic hepatitis b liver failure: classification and regression tree analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848208/ https://www.ncbi.nlm.nih.gov/pubmed/31712684 http://dx.doi.org/10.1038/s41598-019-53029-0 |
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