BMC Gastroenterology最新文献

{"title":"Development and validation of a real-time AI model for differentiating benign and malignant gastric ulcers : a multicenter retrospective study.","authors":"Yibo Tan, Yongjun Wu, Mei Yang, Yan Li, Xiaofei Bi, Song He, Zhihang Zhou, Junyu Lu","doi":"10.1186/s12876-026-04848-9","DOIUrl":"https://doi.org/10.1186/s12876-026-04848-9","url":null,"abstract":"<p><strong>Aim: </strong>To develop and validate a deep learning-based AI system for the dynamic, real-time differentiation of benign and malignant gastric ulcers during endoscopy, with the goal of enhancing diagnostic precision.</p><p><strong>Methods: </strong>This was a multicenter, retrospective study collecting endoscopic images and videos from four tertiary hospitals in China. An improved YOLOv8 model, incorporating an illumination attention module, was developed for real-time instance segmentation and classification. The dataset comprised 9,820 benign ulcer images, 1,727 malignant ulcer images, and 15,791 normal mucosa images, split into training, testing, and validation sets at an 8:1:1 ratio. Performance was evaluated based on precision, recall, specificity, and processing latency.</p><p><strong>Results: </strong>On the validation set, the AI model achieved an overall precision, recall, and specificity of 0.91, 0.91, and 0.95, respectively. For malignant ulcer recognition specifically, the precision, recall, and specificity were 0.90, 0.91, and 0.99. The model demonstrated strong real-time performance with a latency of 8.84 ms per frame and a processing speed of 113 frames per second.</p><p><strong>Conclusion: </strong>The developed AI model enables accurate, real-time discrimination between benign and malignant gastric ulcers during endoscopy. It holds potential to augment clinical decision-making, standardize diagnostic quality, and optimize biopsy strategies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peptic ulcer disease in hospitalized patients: a comprehensive risk factor analysis using a validated checklist.","authors":"Noorollah Tahery, Alireza Baghrobehbahani, Razieh Mohammadzadeh, Amirhossein Alaviyan, Rasool Paygozar, Mona Ebrahimzadeh, Mohsen Shafiee","doi":"10.1186/s12876-026-04711-x","DOIUrl":"https://doi.org/10.1186/s12876-026-04711-x","url":null,"abstract":"<p><strong>Background: </strong>Peptic ulcer disease (PUD) remains a significant public health concern globally, particularly in regions with high prevalence of risk factors such as Helicobacter pylori infection and Non-Steroidal Anti-Inflammatory Drug (NSAID) use. This study aimed to investigate the prevalence of PUD and its associated risk factors among hospitalized patients in a tertiary hospital in southwest Iran.</p><p><strong>Methods: </strong>A mixed-methods design was employed, including a comprehensive literature review, checklist development and validation via a modified Delphi process, a cross-sectional prevalence study, and a hospital-based case-control study. Data were collected from 43,324 patient records (2019-2023) at Abadan University Teaching Hospital. Risk factors were assessed using a validated 21-item checklist, and multivariate logistic regression was used to identify independent predictors of PUD.</p><p><strong>Results: </strong>Among all admissions, 6,874 cases of PUD were identified, indicating a point prevalence of 15.9% (95% CI: 15.6-16.2). NSAID use (75.3%), H. pylori infection (70.1%), smoking (46.9%), and corticosteroid use (30.2%) were highly prevalent among PUD patients. Significant independent risk factors included age ≥ 60 years (AOR: 1.65), NSAID use (AOR: 2.58), H. pylori positivity (AOR: 2.41), smoking (AOR: 1.45), and ulcer size ≥ 5 mm (AOR: 2.19). Despite the high rate of NSAID use, only 26.4% received gastroprotective therapy.</p><p><strong>Conclusions: </strong>The findings underscore the high burden of PUD in hospitalized patients in southwest Iran, with modifiable risk factors such as NSAID use, H. pylori infection, and smoking playing a critical role. Targeted interventions, including Proton Pump Inhibitor (PPI) co-prescription, H. pylori eradication, and lifestyle modifications, are essential to reduce PUD incidence and its complications.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided drainage for pelvic abscesses: a Chinese single-center two-year follow-up study highlighting clinical outcomes.","authors":"Tao Yang, Yi Lu, Wenru Li, Jun Deng, Tao Liu, Yanan Liu, Min Zhi, Jiachen Sun","doi":"10.1186/s12876-026-04741-5","DOIUrl":"https://doi.org/10.1186/s12876-026-04741-5","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS)- guided drainage has emerged as a novel technique for managing pelvic abscesses. This single-center retrospective case series aims to assess the safety and efficacy of EUS-guided drainage in treating pelvic abscesses of varying etiologies from 2021 to the present.</p><p><strong>Methods: </strong>Consecutive patients with pelvic abscesses who underwent EUS-guided drainage were retrospectively reviewed. Etiologies included appendiceal abscess secondary to acute appendicitis (n = 1), pelvic abscesses resulting from anastomotic leaks following rectal cancer surgery (n = 2), and perianal abscesses associated with Crohn's disease (n = 7). The primary outcome was technical success and reduction in abscess cavity size, assessed via follow-up imaging. Clinical success was defined as significant reduction or complete resolution of the abscess cavity size on follow-up imaging at one-month post-procedure, accompanied by clinical symptom resolution and without the need for additional interventions. Secondary outcomes included post-procedural complications and resolution of the abscess without additional interventions.</p><p><strong>Results: </strong>EUS-guided drainage was technically successful in all cases. The median reduction in abscess size was statistically significant (Mean SD: 24.1 ± 11.11, p < 0.05). During follow-up, imaging results confirmed significant reduction in the size of pelvic abscesses in 9 patients, except for one case at the 1-month post-procedure. None of the patients required further surgical intervention, and 2 cases recurrences were observed in the sixth- and tenth-months post-procedure. Additionally, no procedure-related complications were reported.</p><p><strong>Conclusion: </strong>EUS-guided drainage is a safe and effective therapeutic option for managing pelvic abscesses of various etiologies. Its efficacy, particularly in Crohn's disease-related cases, and the absence of complications in this cohort, suggest significant potential for broader clinical application.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic partial hepatectomy for primary hepatic PEComa: a case report.","authors":"Bing Liang, Hongjin Shi, Qingbin Zeng, Xin Tie, Kui Long","doi":"10.1186/s12876-026-04884-5","DOIUrl":"https://doi.org/10.1186/s12876-026-04884-5","url":null,"abstract":"<p><strong>Introduction: </strong>Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors composed of cells exhibiting an epithelioid morphology. These cells typically arrange around small blood vessels (perivascular spaces) and display dual differentiation characteristics of smooth muscle cells and melanocytes. Diagnosis is challenging due to the absence of specific symptoms or tumor markers. This case features a young male patient with a large hepatic PEComa, whose imaging findings resemble those of hepatocellular carcinoma. We have detailed the entire process from diagnosis to treatment to aid in differential diagnosis and surgical planning.</p><p><strong>Case: </strong>A 31-year-old male patient with no prior medical history underwent a routine health examination 20 days prior to presentation. Although the patient was asymptomatic, ultrasound revealed an incidental hepatic lesion measuring 58 × 50 × 45 mm (maximum diameter 58 mm, or 5.8 cm). The screening center suspected a hemangioma. Subsequently, he presented to our hospital. Comprehensive imaging studies, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), revealed a 58 mm-diameter space-occupying lesion in segments V and VIII of the right hepatic lobe. Imaging findings initially raised suspicion for hepatocellular carcinoma. To minimize surgical trauma and preserve liver function, our team discussed surgical approaches and ultimately decided on a laparoscopic partial hepatectomy. During the procedure, we obtained a specimen for pathological examination. The final histopathological analysis confirmed the diagnosis of a PEComa with undetermined malignant potential. The patient recovered smoothly postoperatively and was successfully discharged.</p><p><strong>Conclusion: </strong>PEComa has an insidious onset and is rare. Early diagnosis is often challenging, and imaging studies typically show no highly specific findings. Clinical diagnosis frequently relies on biopsy. In terms of treatment, radical resection (R0 resection, i.e., negative margins) represents the definitive therapeutic approach.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of hepatic reserve and changes in liver and spleen volume after balloon-occluded retrograde transvenous obliteration.","authors":"Kazuma Shinkai, Ryotaro Sakamori, Ryoko Yamada, Yuki Tahata, Kazuki Maesaka, Kengo Matsumoto, Yasutoshi Nozaki, Seiichi Tawara, Hisashi Ishida, Yuichi Yoshida, Satoshi Tanaka, Toshifumi Ito, Yoshinori Doi, Sadaharu Iio, Mitsuru Sakakibara, Fumihiko Nakanishi, Kazuhiro Murai, Yoshinobu Saito, Akira Nishio, Kunimaro Furuta, Takahiro Kodama, Hayato Hikita, Tomohide Tatsumi, Tetsuo Takehara","doi":"10.1186/s12876-026-04893-4","DOIUrl":"https://doi.org/10.1186/s12876-026-04893-4","url":null,"abstract":"<p><strong>Background and aims: </strong>Improvement in hepatic reserve after balloon-occluded retrograde transvenous obliteration (BRTO) in patients with gastric varices (GVs) has not been fully established. The relationship between increases in liver volume (LV) or splenic volume (SV) after BRTO and prognosis is still unclear. In this study, we aimed to evaluate the factors associated with improvement in hepatic reserve after BRTO in GV patients and the relationship between changes in LV or SV after BRTO and prognosis.</p><p><strong>Methods: </strong>We retrospectively enrolled 258 patients who recieved their first BRTO for GV treatment at 12 institutions between January 2004 and May 2019. Hepatic reserve, LV, and SV were evaluated before and 6 months after BRTO.</p><p><strong>Results: </strong>Changes in hepatic reserve were evaluated in 160 patients. Albumin levels and prothrombin time-international normalized ratio improved significantly, while platelet counts decreased significantly at 6 months after BRTO. Multivariate logistic regression analysis showed that history of hepatocellular carcinoma and modified albumin-bilirubin (mALBI) grade were independent factors associated with the improvement of albumin-bilirubin (ALBI) score. The ALBI score significantly improved in patients with mALBI grade 2b or 3 (p < 0.001), but not in patients with mALBI grade 1 or 2a. Eighty-three patients who underwent abdominal computed tomography examination 6 months after BRTO had significantly increased LV and SV (LV, p < 0.01; SV, p < 0.01). The patients with a > 10% increase in SV had significantly poorer prognosis than the others (p = 0.03).</p><p><strong>Conclusions: </strong>BRTO for GVs leads to improvement of hepatic reserve. Patients with increased SV after BRTO had poor prognosis.</p><p><strong>Trial registration: </strong>Not aplicable.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplantation for Wilson disease: a spectrum from acute liver failure to Neuro-Wilson.","authors":"Saad Alghamdi, Dimitri A Raptis, Ibrahim Alomar, Wejdan Alotaibi, Abeer Alabdullah, Bandar Aljudaibi, Ali Albenmousa, Khalid Bzeizi, Saleh A Alqahtani, Dieter C Broering, Waleed Al-Hamoudi","doi":"10.1186/s12876-026-04879-2","DOIUrl":"https://doi.org/10.1186/s12876-026-04879-2","url":null,"abstract":"<p><strong>Introduction: </strong>Wilson disease (WD) is a rare autosomal recessive disorder of copper metabolism presenting with acute liver failure, cirrhosis, or neurologic involvement. Liver transplantation (LT) is the definitive treatment; however, data remain limited, particularly from regions reliant on living donor LT (LDLT).</p><p><strong>Methods: </strong>We retrospectively analyzed a prospectively collected transplant database, identifying all patients (≥ 14 years) who underwent LT for WD between January 2001 and December 2023. Data on demographics, LT indications, disease characteristics, pre-transplant therapy, complications, and outcomes were collected. Survival was assessed using Kaplan-Meier methods, and neurologic outcomes from clinical documentation.</p><p><strong>Results: </strong>Forty-one patients underwent LT for WD (median age: 23 years; 51.2% female). Ascites was present in 68.4%, encephalopathy in 32.4%, and hepatocellular carcinoma in 5.1%. Acute liver failure was the initial presentation in 17.9%. LDLT comprised 53.7%. Acute cellular rejection occurred in 29.7% but was manageable; no patient required re-transplantation. Neurologic involvement was present in 17.1%, with 71% improving post-LT. One-, five-, and ten-year survival rates were 94%, 94%, and 82%.</p><p><strong>Conclusion: </strong>LT for WD yields excellent long-term survival. Neurologic improvement occurred in most Neuro-Wilson patients, supporting LT even in neurologically affected cases. LDLT plays a crucial role in regions with limited deceased donors.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value and safety of liver biopsy in patients with liver failure.","authors":"Jingran Jiao, Rui Zhao, Yongping Zhang, Manman Xu, Yu Chen","doi":"10.1186/s12876-026-04863-w","DOIUrl":"https://doi.org/10.1186/s12876-026-04863-w","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the safety, etiological diagnostic value, and impact on clinical treatment decisions of transjugular liver biopsy (TJLB) and percutaneous liver biopsy (PLB) in patients with liver failure.</p><p><strong>Methods: </strong>This retrospective study included patients with liver failure who underwent liver biopsy between January 1, 2017, and November 30, 2025. Demographic characteristics, clinical data, post-procedural adverse events, and pathological diagnoses were collected and subjected to statistical analysis.</p><p><strong>Results: </strong>A total of 53 patients with liver failure were included, comprising 40 patients with acute-on-chronic liver failure (ACLF) and 13 patients with acute or subacute liver failure. 13 patients received TJLB, all of whom had ACLF. Compared with the PLB, patients in the TJLB group had a higher international normalized ratio (INR) [1.61 (1.32, 1.98)], a lower platelet count (PLT) [89.00 (73.00, 129.00) × 10⁹/L], and were more frequently complicated by moderate to large ascites. Both PLB and TJLB were successfully performed, with a low overall complication rate and no serious adverse events. Even among patients with marked coagulation abnormalities or concomitant ascites, TJLB demonstrated acceptable safety. Histopathological examination following liver biopsy enables reclassification of both chronic liver disease etiologies and acute precipitating factors in patients with ACLF, as well as etiological diagnoses in patients with acute liver failure (ALF) or subacute liver failure (SALF). A substantial proportion of drug- or toxin-related acute liver injury was identified by histopathological examination (n = 32, 60%), leading to a decreased proportion of liver failure with unclear etiology. Based on the pathological diagnosis, treatment strategies were modified in 11% of patients, including the initiation or continuation of specific therapeutic regimens.</p><p><strong>Conclusions: </strong>In patients with liver failure, liver biopsy provides crucial information for determining the etiology and guiding clinical decision-making. With appropriate selection of the biopsy approach and patient population, TJLB can serve as a safe and feasible option, particularly for patients with coagulation disorders or severe ascites.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed duodenal tumors at upper endoscopy: a five year retrospective cohort study at West China hospital (2019-2023).","authors":"Yaxin Li, Yuan Li, Zhujun Wu, Linjie Guo","doi":"10.1186/s12876-026-04883-6","DOIUrl":"https://doi.org/10.1186/s12876-026-04883-6","url":null,"abstract":"<p><strong>Background: </strong>Duodenal tumors constitute 35%-55% of small bowel neoplasms, yet the misdiagnosis rate remains substantial. This study investigated the clinical features of duodenal tumors missed during endoscopic examination.</p><p><strong>Methods: </strong>This retrospective cohort analysis included patients who were diagnosed with duodenal tumors between 2019 and 2023 at West China Hospital. Demographic data, tumor characteristics, endoscopic findings, and missed diagnosis records were extracted from electronic medical records and telephone follow-ups. The exploratory analysis identified the reasons for the missed diagnosis during endoscopy.</p><p><strong>Results: </strong>Among the 307 enrolled patients with duodenal tumors, 36 patients (34 with adenocarcinomas and 2 with neuroendocrine tumors) had undergone previous endoscopic examinations without a definitive diagnosis, yielding a missed detection rate of 11.7%. In all missed cases, the mean number of endoscopic procedures performed prior to definitive diagnosis was 2 (range: 1-8), with an average interval of 11.1 months (range: 3-36 months). The anatomical distribution of missed lesions included the duodenal papilla (44.4%, 16/36), duodenal bulb (25.0%, 9/36), bulb-descending junction (5.6%, 2/36), descending (13.9%, 5/36) and horizontal (5.6%, 2/36) parts. The causes of missed diagnoses included exposure errors (n = 20), judgment errors (n = 5), biopsy errors (n = 8), and unclassified errors (n = 3). The difference in the pattern of missed duodenal tumors between tertiary hospitals and non-tertiary hospitals was not statistically significant (P > 0.05).</p><p><strong>Conclusion: </strong>The missed diagnosis rate of duodenal tumors is high during endoscopic examination. Comprehensive endoscopic observation and improved detection awareness of duodenal tumors are essential in both tertiary and nontertiary hospitals.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated routine laboratory indices for risk stratification in HBV-related cirrhosis: a real-world study.","authors":"Lin Zhang, Liang Li, Xiaowei Du, Suhua Pang, Youde Yan, Zhenjiang Zhang","doi":"10.1186/s12876-026-04869-4","DOIUrl":"https://doi.org/10.1186/s12876-026-04869-4","url":null,"abstract":"<p><strong>Background: </strong>Chronic hepatitis B (CHB) is characterized by progressive structural and functional liver impairment involving hepatic dysfunction, fibrosis accumulation, and nutritional-immune imbalance. Although non-invasive indices derived from routine laboratory parameters-such as the albumin-bilirubin (ALBI) score, fibrosis-4 (FIB-4) index, and prognostic nutritional index (PNI)-are widely used, their integrated value for stage-based risk stratification in HBV-related liver disease remains unclear.</p><p><strong>Aims: </strong>To develop and internally validate a clinically applicable, non-invasive risk stratification framework based on ALBI, FIB-4, and PNI, and to evaluate its performance across different clinical stages of HBV-related liver disease.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cross-sectional study including 842 hospitalized patients with HBV-related liver disease. Patients were categorized as chronic hepatitis B, compensated cirrhosis, or decompensated cirrhosis at admission. ALBI, FIB-4, and PNI were calculated from routine laboratory data. Ordinal logistic regression was used to identify factors associated with advanced disease stage. Discriminative performance was assessed using receiver operating characteristic (ROC) analysis, and calibration was evaluated. Factors associated with hepatic encephalopathy were explored in patients with decompensated cirrhosis.</p><p><strong>Results: </strong>ALBI and FIB-4 increased with higher disease stage, whereas PNI declined significantly (all P < 0.001). Multivariable analysis identified age, ALBI, and FIB-4 as independent factors associated with advanced stage, while PNI and platelet count were inversely associated. The combined framework was associated with improved discrimination for disease stages compared with individual indices, with further enhancement after incorporation of prothrombin time (PT). Higher ALBI values were independently associated with hepatic encephalopathy among patients with decompensated cirrhosis.</p><p><strong>Conclusions: </strong>An integrated framework combining ALBI, FIB-4, PNI, and PT may provide a simple, interpretable, and cost-accessible tool for stage-based risk stratification in HBV-related liver disease within hospitalized populations.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypotension among patients with liver failure treated by artificial liver support system: risk factors and coping strategies.","authors":"Junjie Liu, Xiufen Liu, Muqingzi Wang, Shan Wei, Deliang Hu, Yongxia Gao","doi":"10.1186/s12876-026-04760-2","DOIUrl":"https://doi.org/10.1186/s12876-026-04760-2","url":null,"abstract":"<p><strong>Background: </strong>Artificial Liver Support System (ALSS) is a core therapeutic modality for liver failure, but hypotension is a common and severe complication during treatment, which may lead to treatment interruption and poor prognosis. This study aims to explore the independent risk factors of hypotension complicating ALSS treatment for liver failure, construct a predictive model, and provide evidence for clinical coping strategies.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted. According to the occurrence of hypotension during treatment, they were divided into the hypotension group and the non-hypotension group. Clinical data of the two groups were collected and analyzed.</p><p><strong>Results: </strong>216 patients with liver failure who received ALSS treatment were included. Multivariate logistic regression analysis confirmed that age ≥ 65 years (OR = 2.379, 95%CI:1.568 ~ 3.605), BMI < 19 kg/m² (OR = 2.782, 95%CI:1.825 ~ 4.226), ALSS treatment duration > 4 h (OR = 2.598, 95%CI:1.689 ~ 3.987), hypokalemia (OR = 2.193, 95%CI:1.452 ~ 3.298) and hypoalbuminemia (OR = 3.099, 95%CI:2.015 ~ 4.756) were independent risk factors for hypotension (all P < 0.001). The constructed scoring predictive model had excellent discriminative efficacy with an AUC of 0.888 (95%CI:0.840 ~ 0.936), and the highest Youden's index (0.642) was obtained when the scoring threshold was 6.5 points.</p><p><strong>Conclusion: </strong>The simplified scoring model exhibits favorable predictive efficacy, enabling early identification and risk stratification of high-risk patients. Implementation of multidimensional prevention strategies-including precision treatment optimization, individualized nursing interventions, and integrated process management-may reduce the incidence of hypotension and improve treatment safety.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}