[Construction of a predictive model for recompensation in patients with decompensated viral hepatitis-induced cirrhosis].

Abstract

Objective: To explore the influencing factors and construct a predictive model for recompensation in patients with decompensated viral hepatitis-induced cirrhosis. Methods: Data were retrospectively collected from 734 cases diagnosed with decompensated hepatitis B and C-induced cirrhosis who visited the Third People's Hospital of Kunming between January 1, 2016 and December 31, 2022. Patients without portal hypertension-related complications within at least one year were included in the recompensation group (n=270), while those without recompensation were included in the persistent decompensation group (n=464). Logistic regression analysis was performed on factors that influence recompensation. The discriminant power of the model was evaluated using the area under the receiver operating characteristic curve (AUC), and the calibration of the model was evaluated using the Hosmer-Lemeshow test and calibration plot. A nomogram-based risk prediction model was established using the "rms" package. Continuous data were compared using the independent samples t-test or rank-sum test between the groups. Categorical data were compared using the χ² test or Fisher's exact test between the groups. Results: Recompensated occurred in 270 of the 734 patients with viral hepatitis cirrhosis decompensation, with an incidence rate of 36.78%. Multivariate logistic regression analysis results showed that gender [odds ratio (OR)=0.602, P=0.044], history of transjugular intrahepatic portosystemic shunt (OR=6.517, P=0.005), oral administration of nonselective β receptor blockers (OR=2.353, P=0.015), sustained virological response (OR=4.639, P<0.001), hemoglobin (OR=1.012, P=0.010), albumin (OR=1.101, P<0.001), and portal vein width (OR=0.730, P<0.001) were independent influencing factors for recompensation in patients with decompensated viral hepatitis-induced cirrhosis. The P value of the constructed prediction model was >0.05 in the modeling group and the validation group, and the area under the receiver operating characteristic curve was 0.776 and 0.724, respectively. Conclusion: Patients with decompensated viral hepatitis cirrhosis who have a history of transjugular intrahepatic portosystemic shunt (TIPS), sustained virological response, and oral administration of non-β-selective receptor blockers are more likely to undergo recompensation, while male patients and those with low hemoglobin, low albumin, and increased portal vein width are less likely to undergo recompensation. The constructed nomogram predictive model can effectively assess the occurrence of recompensation in patients with decompensated-stage viral hepatitis cirrhosis.