Establishment and Evaluation of a Nomogram for Predicting Potential Death in Patients with Hepatitis C Cirrhosis and Sepsis in General Wards

Linlin XUE; Binghan LI; Chunyun LIU; Weikun LI; Lixian CHANG; Huimin LI; Yanwei QI; Li LIU

doi:10.12259/j.issn.2095-610X.S20230630

Volume 44 Issue 6

Jun. 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(6): 113-119

Linlin XUE, Binghan LI, Chunyun LIU, Weikun LI, Lixian CHANG, Huimin LI, Yanwei QI, Li LIU. Establishment and Evaluation of a Nomogram for Predicting Potential Death in Patients with Hepatitis C Cirrhosis and Sepsis in General Wards[J]. Journal of Kunming Medical University, 2023, 44(6): 113-119. doi: 10.12259/j.issn.2095-610X.S20230630

Citation:

Linlin XUE, Binghan LI, Chunyun LIU, Weikun LI, Lixian CHANG, Huimin LI, Yanwei QI, Li LIU. Establishment and Evaluation of a Nomogram for Predicting Potential Death in Patients with Hepatitis C Cirrhosis and Sepsis in General Wards[J]. Journal of Kunming Medical University, 2023, 44(6): 113-119. doi: 10.12259/j.issn.2095-610X.S20230630

Citation:

Linlin XUE, Binghan LI, Chunyun LIU, Weikun LI, Lixian CHANG, Huimin LI, Yanwei QI, Li LIU. Establishment and Evaluation of a Nomogram for Predicting Potential Death in Patients with Hepatitis C Cirrhosis and Sepsis in General Wards[J]. Journal of Kunming Medical University, 2023, 44(6): 113-119. doi: 10.12259/j.issn.2095-610X.S20230630

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Establishment and Evaluation of a Nomogram for Predicting Potential Death in Patients with Hepatitis C Cirrhosis and Sepsis in General Wards

doi: 10.12259/j.issn.2095-610X.S20230630

1.
School of Public Health，Dali University，Dali Yunnan 671000
2.
Dept. of Liver Diseases and Immunology，Yunnan Provincial Clinical Medical Center for Infectious Diseases，The Third People’s Hospital of Kunming，Kunming Yunnan 650041，China

Received Date: 2023-03-03
Available Online: 2023-06-19
Publish Date: 2023-06-25

Abstract

Abstract

Objective To explore the predictive factors of potential mortality in patients with hepatitis C cirrhosis and sepsis in general wards. Methods A retrospective analysis was performed on 194 patients with hepatitis C cirrhosis and sepsis diagnosed in the Third People’s Hospital of Kunming City from January 2012 to August 2022. Clinical data such as gender, age, comorbidity, site of infection, history of invasive operation within the last 2 weeks, MEWS score, length of stay, white blood cell/platelet, neutrophil count/lymphocyte count ratio （NLR）, red blood cell and prothrombin time were collected. According to the prognosis, the patients were divided into two groups: death group （n = 13） and survival group （n = 181）. The differences of various indicators between the two groups were analyzed and compared, and the influencing factors of death were analyzed. Results A total of 194 patients were included in the analysis, including 151 males （77.8%） and 43 females （22.2%）. The average age was 50.6±9.7 years. There were 32 cases （16.5%） with hypertension and 32 cases （16.5%） with diabetes. Multivariate Logistic regression analysis showed that HCV infection time （OR = 1.114; 95%CI 1.000, 1.241）, MEWS score （OR = 1.761; 95%CI 1.210, 2.564）, no co-infection （OR = 0.081; 95%CI 0.010, 0.667）, neutrophil/lymphocyte ratio （NLR）（OR = 1.084; 95%CI 1.021, 1.152） was an independent predictor of potential death in patients with hepatitis C cirrhosis and sepsis in the general ward. The sensitivity and specificity of the nomogram model are 92.3%, 81.2%, respectively; and the maximum Youden index is 0.735. The result of Hosmer-Lemeshaw test is χ² = 2.471, P = 0.963 （P > 0.05）, which indicates that the model fits well. ROC curve analysis showed that AUC = 0.916, 95%CI 0.856, 0.976. Calibration images of the Nomogram was used to verify the diagnostic value of the Nomogram model with an average absolute error of 0.022. The results showed that the actual and predicted values of bacterial infection were in good consistency. Conclusion Time of HCV infection, MEWS score, unco-infected, and NLR were associated with the risk of death from hepatitis C cirrhosis and sepsis. MEWS combined diagnosis can improve the accuracy of predicting death in patients with hepatitis C cirrhosis and sepsis in general wards.
- Modified early warning score,
- Sepsis,
- Hepatitis C cirrhosis,
- Death,
- Nomogram

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