PDF(Pubmed)
Abstract：
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhosis patients with ascites, leading to high mortality rates if not promptly treated. However, specific prediction models for SBP are lacking.
OBJECTIVE: This study aimed to compare commonly used cirrhotic prediction models (CTP score, MELD, MELD-Na, iMELD, and MELD 3.0) for short-term mortality prediction and develop a novel model to improve mortality prediction.
METHODS: Patients with the first episode of SBP were included. Prognostic values for mortality were assessed using AUROC analysis. A novel prediction model was developed and validated.
RESULTS: In total, 327 SBP patients were analyzed, with HBV infection as the main etiologies. MELD 3.0 demonstrated the highest AUROC among the traditional models. The novel model, incorporating HRS, exhibited superior predictive accuracy for in-hospital in all patients and 3-month mortality in HBV-cirrhosis, with AUROC values of 0.827 and 0.813 respectively, surpassing 0.8.
CONCLUSIONS: MELD 3.0 score outperformed the CTP score and showed a non-significant improvement compared to other MELD-based scores, while the novel SBP model demonstrated impressive accuracy. Internal validation and an HBV-related cirrhosis subgroup sensitivity analysis supported these findings, highlighting the need for a specific prognostic model for SBP and the importance of preventing HRS development to improve SBP prognosis.
OBJECTIVE: This study aimed to compare commonly used cirrhotic prediction models (CTP score, MELD, MELD-Na, iMELD, and MELD 3.0) for short-term mortality prediction and develop a novel model to improve mortality prediction.
METHODS: Patients with the first episode of SBP were included. Prognostic values for mortality were assessed using AUROC analysis. A novel prediction model was developed and validated.
RESULTS: In total, 327 SBP patients were analyzed, with HBV infection as the main etiologies. MELD 3.0 demonstrated the highest AUROC among the traditional models. The novel model, incorporating HRS, exhibited superior predictive accuracy for in-hospital in all patients and 3-month mortality in HBV-cirrhosis, with AUROC values of 0.827 and 0.813 respectively, surpassing 0.8.
CONCLUSIONS: MELD 3.0 score outperformed the CTP score and showed a non-significant improvement compared to other MELD-based scores, while the novel SBP model demonstrated impressive accuracy. Internal validation and an HBV-related cirrhosis subgroup sensitivity analysis supported these findings, highlighting the need for a specific prognostic model for SBP and the importance of preventing HRS development to improve SBP prognosis.
摘要：
背景：自发性细菌性腹膜炎（SBP）是肝硬化腹水患者的严重并发症，如果不及时治疗，会导致高死亡率。然而,缺乏针对SBP的具体预测模型。
目的：本研究旨在比较常用的肝硬化预测模型（CTP评分，MELD,MELD-Na,IMELD,和MELD3.0）用于短期死亡率预测，并开发一种新颖的模型来改善死亡率预测。
方法：纳入首次SBP发作的患者。使用AUROC分析评估死亡率的预后值。建立并验证了一种新的预测模型。
结果：总计，327例SBP患者进行了分析，以HBV感染为主要病因。MELD3.0在传统模型中表现出最高的AUROC。新颖的模型，合并HRS，表现出优越的预测准确性，在所有患者和3个月的死亡率在乙肝肝硬化，AUROC值分别为0.827和0.813，超过0.8
结论：MELD3.0评分优于CTP评分，与其他基于MELD的评分相比，没有显着改善，而新的SBP模型表现出令人印象深刻的准确性。内部验证和HBV相关的肝硬化亚组敏感性分析支持这些发现，强调需要针对SBP的特定预后模型以及预防HRS发展以改善SBP预后的重要性。
目的：本研究旨在比较常用的肝硬化预测模型（CTP评分，MELD,MELD-Na,IMELD,和MELD3.0）用于短期死亡率预测，并开发一种新颖的模型来改善死亡率预测。
方法：纳入首次SBP发作的患者。使用AUROC分析评估死亡率的预后值。建立并验证了一种新的预测模型。
结果：总计，327例SBP患者进行了分析，以HBV感染为主要病因。MELD3.0在传统模型中表现出最高的AUROC。新颖的模型，合并HRS，表现出优越的预测准确性，在所有患者和3个月的死亡率在乙肝肝硬化，AUROC值分别为0.827和0.813，超过0.8
结论：MELD3.0评分优于CTP评分，与其他基于MELD的评分相比，没有显着改善，而新的SBP模型表现出令人印象深刻的准确性。内部验证和HBV相关的肝硬化亚组敏感性分析支持这些发现，强调需要针对SBP的特定预后模型以及预防HRS发展以改善SBP预后的重要性。
