Application of a biochemical and clinical model to predict individual survival in patients with end-

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:birdinfly
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
AIM:To investigate the capability of a biochemical and clinical model,BioCliM,in predicting the survival of cirrhotic patients.METHODS:We prospectively evaluated the survival of 172 cirrhotic patients.The model was constructed using clinical(ascites,encephalopathy and variceal bleeding) and biochemical(serum creatinine and serum total bilirubin) variables that were selected from a Cox proportional hazards model.It was applied to estimate 12-,52-and 104-wk survival.The model’s calibration using the Hosmer-Lemeshow statistic was computed at 104 wk in a validation dataset.Finally,the model’s validity was tested among an independent set of 85 patients who were stratified into 2 risk groups(low risk≤8 and high risk>8).RESULTS:In the validation cohort,all measures of fi t,discrimination and calibration were improved when the biochemical and clinical model was used.The proposed model had better predictive values(c-statistic:0.90,0.91,0.91) than the Model for End-stage Liver Disease(MELD) and Child-Pugh(CP) scores for 12-,52-and 104-wk mortality,respectively.In addition,the Hosmer-Lemeshow(H-L) statistic revealed that the biochemical and clinical model(H-L,4.69) is better calibrated than MELD(H-L,17.06) and CP(H-L,14.23).There were no significant differences between the observed and expected survival curves in the stratified risk groups(low risk,P=0.61;high risk,P=0.77).CONCLUSION:Our data suggest that the proposed model is able to accurately predict survival in cirrhotic patients. AIM: To investigate the capability of a biochemical and clinical model, BioCliM, in predicting the survival of cirrhotic patients. METHODS: We prospectively evaluated the survival of 172 cirrhotic patients. The model was constructed using clinical (ascites, encephalopathy and variceal bleeding) and biochemical (serum creatinine and serum total bilirubin) variables that were selected from a Cox proportional hazards model. It was applied to estimate 12-, 52-and 104-wk survival. The model’s calibration using the Hosmer-Lemeshow statistic was computed at 104 wk in a validation dataset. Finaally, the model’s validity was tested among an independent set of 85 patients who were stratified into 2 risk groups (low risk≤8 and high risk> 8) .RESULTS: In the validation cohort, all measures of fi t , discrimination and calibration were improved when the biochemical and clinical model was used. The proposed model had better predictive values ​​(c-statistic: 0.90,0.91,0.91) than the Model for End-stage Liver Disease (MELD) an The Child-Pugh (CP) scores for 12-, 52- and 104-wk mortality, respectively. In addition, the Hosmer-Lemeshow (HL) statistic revealed that the biochemical and clinical model (HL, 4.69) is better calibrated than MELD (HL, 17.06) and CP (HL, 14.23) .There was no significant differences between the observed and expected survival curves in the stratified risk groups (low risk, P = 0.61; high risk, P = 0.77) .CONCLUSION: Our data suggest that the proposed model is able to accurately predict survival in cirrhotic patients.
其他文献
加德纳(1943年——)哈佛大学心理学教授,1967年,当他还是学生的时候,参加了由他的老师哲学家哥德曼教授主持的0点计划课题研究,所谓0点计划,是研究艺术思维的。0点计划是美
同学们是不是都喜欢星期天呢?  周日早晨,太阳初升,小明睡得正香。忽然“你若化成风,我便化成雨……”的手机铃声把小明惊醒了,小明抓起手机一看,原来是小王打过来的。  “小王,这么早就打电话,啥事啊?”小明慵懒地说。  “小明,又睡懒觉了吧,现在都快8点了。不早了,快点,到小湖公园里来打桥牌,三缺一。’  一听说打桥牌,小明立马来了精神。他飞快地下床穿好了衣服,然后急匆匆地洗漱了一番,就准备出门。 
每一堂成功的课,每一种优秀的教学方法,都应当把激发学生的学习兴趣和热情,充分调动学生学习积极性和主动性,作为出发点。经过课改,新教材展现了趣味性、可读性和启发性,但是
每一个人都希望自己健康、长寿,老年人更是如此。进入老年期以后,在老态龙钟的同时,也极易发生精神衰老和心理危机。常见的心理危机主要表现为以下几种: 孤独心理 有些老年
智力发展问题是心理学上一个重要而复杂的理论问题,且有很多争论。国内在这方面的材料还不充分。这里仅就我个人的理解谈一些初步看法,以期引起对这个问题的讨论。 Intelle
请下载后查看,本文暂不支持在线获取查看简介。 Please download to view, this article does not support online access to view profile.
心理健康教育是当前中小学教育中的热点问题,心理健康教育活动已在全国各地的中小学蓬勃开展。心理健康教育主要是通过心理素质训练课、学科渗透、咨询辅导和其他形式的活动展
当今,我国职业教育快速发展,是实现“普高”的另一大军。进入中职学校的大多数学生成绩偏差,初中阶段的数学基础较差,没有养成良好的学习习惯,给中职阶段的课堂教学带来了很
目的探讨经中央沟下点-脑岛入路显微手术清除高血压基底核区血肿的改良方法和治疗效果。方法回顾性分析22例采用改良显微手术清除高血压基底核区脑出血病人的临床资料。开颅
①初识耄耋之年的吴孟超院士,所有的人都会为他半个世纪“披肝沥胆”所创造的辉煌业绩而惊叹;但也会觉得,面对他这本几近神话的“大书”无从读起。②其实,解读吴老并不难,看