|
|
|
| Development and validation of a novel model to predict liver-related mortality in patients with idiosyncratic drug-induced liver injury |
| Yan Wang a , # , Cai-Lun Zou a , # , Jing Zhang b , Li-Xia Qiu b , Yong-Fa Huang c , d , Xin-Yan Zhao a , Zheng-Sheng Zou e , ∗, Ji-Dong Jia a , ∗ |
a Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Key Laboratory on Translational Medicine on Cirrhosis; National Clinical Research Center for Digestive Diseases, Beijing 100050, China
b The Third Unit, Department of Hepatology, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China
c Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100050, China
d Clinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing 100050, China
e Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
∗Corresponding authors.
E-mail addresses: zszou302@163.com (Z.-S. Zou), jia_jd@ccmu.edu.cn (J.-D. Jia).
# Contributed equally. |
|
|
|
Abstract Background: Early identification of patients with high mortality risk is critical for optimizing the clinical management of drug-induced liver injury (DILI). We aimed to develop and validate a new prognostic model to predict death within 6 months in DILI patients.
Methods: This multicenter study retrospectively reviewed the medical records of DILI patients admitted to three hospitals. A DILI mortality predictive score was developed using multivariate logistic regression and was validated with area under the receiver operating characteristic curve (AUC). A high-mortality-risk subgroup was identified according to the score.
Results: Three independent DILI cohorts, including one derivation cohort ( n = 741) and two validation co- horts ( n = 650, n = 617) were recruited. The DILI mortality predictive (DMP) score was calculated using parameters at disease onset as follows: 1.913 ×international normalized ratio + 0.060 ×total bilirubin (mg/dL) + 0.439 ×aspartate aminotransferase/alanine aminotransferase –1.579 ×albumin (g/dL) –0.006 ×platelet count (10 9 /L) + 9.662. The predictive performance for 6-month mortality of DMP score was desirable, with an AUC of 0.941 (95% CI: 0.922-0.957), 0.931 (0.908-0.949) and 0.960 (0.942-0.974) in the derivation, validation cohorts 1 and 2, respectively. DILI patients with a DMP score ≥8.5 were stratified into high-risk group, whose mortality rates were 23-, 36-, and 45-fold higher than those of other patients in the three cohorts.
Conclusions: The novel model based on common laboratory findings can accurately predict mortality within 6 months in DILI patients, which should serve as an effective guidance for management of DILI in clinical practice.
|
|
|
|
|
|
| [1] |
. Thanks[J]. Hepatobiliary Pancreat Dis Int, 2023, 22(6): 661-A9. |
|
|
|
|
2023, Vol. 22 
