Construction and validation of the risk prediction model for secondary hepatic encephalopathy in patients with chronic hepatitis B and cirrhosis

Abstract

Abstract: Objective To investigate the risk factors of secondary hepatic encephalopathy (HE) in patients with chronic hepatitis B (CHB) and cirrhosis, construct a risk prediction model, and verify it.Methods A total of 202 patients with CHB and cirrhosis admitted to the hospital from January 2021 to June 2022 were retrospectively analyzed. According to the presence or absence of secondary HE, the patients were divided into HE group (59 cases) and non-HE group (143 cases). Clinical data of the patients were collected. The risk factors were screened by logistic regression analysis, and a prediction model was constructed. The ROC curve was used to verify the predictive performance of this model.Results Logistic regression analysis results showed that transjugular intrahepatic portosystemic stent-shunts (TIPS, OR=3.043), upper gastrointestinal bleeding (OR=4.007), electrolyte acid-base balance disorder (OR=2.401), hepatorenal syndrome (OR=4.540) and constipation (OR=2.838) were risk factors of secondary HE (P<0.05). The risk prediction model was as follow: P=ex/(1+ex), X=-2.375+1.113×TIPS+1.388×upper gastrointestinal bleeding+0.876×electrolyte acid-base balance disorder+1.513× hepatorenal syndrome+1.043×constipation. The area under the ROC curve (AUC), sensitivity, specificity and Youden index were 0.841 (95%CI=0.772, P<0.001), 80.36%, 80.00% and 0.604, respectively.Conclusion The prediction model can help to better predict the occurrence of HE in patients with CHB and cirrhosis. Clinically, the model can be used to evaluate patients with CHB and cirrhosis, thereby assisting in targeted measures to prevent the occurrence of HE.

Key words: Chronic hepatitis B, Cirrhosis, Hepatic encephalopathy, Prediction model

ZHANG Jia-qi, WANG Zai-chao, YANG Jia-yao, WANG Xiao-meng, ZHAO Yu. Construction and validation of the risk prediction model for secondary hepatic encephalopathy in patients with chronic hepatitis B and cirrhosis[J]. Chinese Hepatolgy, 2023, 28(8): 916-920.

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