Influencing factors for 90-day survival and construction of a prediction model in patients with hepatitis B virus-related acute-on-chronic liver failure
WU Xirong
LI Rongting
CHEN Yaqiong
Abstract：Objective To analyze the influencing factors for 90-day survival in patients with hepatitis B virus-relat-ed acute-on-chronic liver failure(HBV-ACLF)and to construct a prediction model.Methods A total of 370 HBV-ACLF patients were divided into two groups based on their 90-day survival status:284 survivors and 86 non-survivors.Clinical and laboratory data of the patients were collected,including age,gender,white blood cell count(WBC),neutro-phil count,lymphocyte count,prothrombin activity(PTA),activated partial thromboplastin time(APTT),α-L-fucosi-dase(AFU),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),direct bilirubin(DBIL),creatinine(Cr),serum sodium(Na),triglycerides(TG),cystatin C(CysC),concur-rent hepatic encephalopathy,and concurrent ascites.Univariate and multivariate Logistic regression analyses were used to identify the independent influencing factors for 90-day survival in HBV-ACLF patients.SPSS 27.0 statistical software was used to construct the prediction model for 90-day survival in HBV-ACLF patients.The area under the receiver operating characteristic(ROC)curve(AUC)was used to compare the predictive performance of the new model with that of classical prediction models,including the Model for End-Stage Liver Disease(MELD)score,MELD-Na score,and MELD 3.0 score.The Hosmer-Lemeshow test was applied to evaluate the goodness of fit of each prediction model,and the Brier score was used to comprehensively assess the accuracy of each model.Results Age,DBIL,and PTA were identified as inde-pendent influencing factors for 90-day survival in HBV-ACLF patients(all P<0.05).The constructed prediction model for 90-day survival in HBV-ACLF patients was defined as:PI=0.062×age(years)+0.004×DBIL(μmol/L)-0.055×PTA(s)-0.239.Compared with the classical prediction models,the new model exhibited the highest AUC and Hosmer-Lemeshow test P-value,as well as the lowest Brier score.Conclusions Age,DBIL and PTA are independent influenc-ing factors for 90-day survival in HBV-ACLF patients.A prediction model for 90-day survival in HBV-ACLF patients is successfully constructed,and this new model shows better predictive performance than the classical models.
Keywords：hepatitis Bacute-on-chronic liver failureprognostic prediction model
Publication Date：2026-01-25
Online Publishing Date：2026-03-05(First online date of this platform, not the publication date of the document)
Pages：4( 114-117 )