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©The Author(s) 2025.
World J Gastroenterol. May 21, 2025; 31(19): 104563
Published online May 21, 2025. doi: 10.3748/wjg.v31.i19.104563
Published online May 21, 2025. doi: 10.3748/wjg.v31.i19.104563
Table 1 Baseline characteristics of Budd-Chiari syndrome patients with gastroesophageal varices stratified by variceal bleeding status
| Variables | Bleeding group (n = 61) | Non-bleeding group (n = 383) | P value |
| Age (years) | 52.1 ± 11.2 | 51.4 ± 10.8 | 0.640 |
| Sex (male) | 50 (82) | 209 (54.6) | < 0.001 |
| Diabetes | 3 (4.9) | 29 (7.6) | 0.633 |
| Ascites | 33 (54.1) | 144 (37.6) | 0.015 |
| Hepatic encephalopathy | 2 (3.3) | 11(2.9) | 1.000 |
| IVC or HV thrombosis | 9 (14.8) | 79 (20.6) | 0.285 |
| Portal vein thrombosis | 7 (11.5) | 16 (4.2) | 0.038 |
| Spleen thickness (mm) | 46 (39, 58) | 45 (39, 49) | 0.041 |
| Portal vein diameter (mm) | 12.7 (10.0, 14.5) | 12.7 (10.0, 15.0) | 0.994 |
| BCS type | 0.042 | ||
| HV type | 19 (31.1) | 67 (17.5) | |
| Mixed type | 35 (57.4) | 269 (70.2) | |
| IVC type | 7 (11.5) | 47 (12.3) | |
| Child-Pugh grade | < 0.001 | ||
| A | 26 (42.6) | 256 (66.8) | |
| B | 21 (34.4) | 121 (31.6) | |
| C | 14 (23) | 6 (1.6) | |
| ALBI, median (IQR) | -2.07 (-2.57, -1.28) | -2.38 (-2.75, -1.97) | < 0.001 |
| MELD, median (IQR) | 8.22 (4.07, 13.00) | 4.15 (1.72, 7.19) | < 0.001 |
| Use of anticoagulant medication | 56 (91.8) | 310 (80.9) | 0.038 |
| Invasive treatment to relieve hepatic venous outflow obstruction | 27 (44.3) | 344 (89.8) | < 0.001 |
| White blood cell (× 109/L) | 3.8 (2.9, 5.0) | 3.4 (2.7, 4.5) | 0.271 |
| Red blood cell (× 1012/L) | 3.7 (2.8, 4.4) | 4.0 (3.6, 4.4) | 0.016 |
| Hemoglobin (g/L) | 115 (77.5, 134.0) | 124 (109, 138) | 0.005 |
| Platelet (× 109/L) | 71 (48.5, 98) | 90 (67, 126) | < 0.001 |
| Sodium (mmol/L) | 140 (137.5, 142.0) | 142 (140, 143.9) | < 0.001 |
| Creatinine (µmol/L) | 62 (48.5, 76.5) | 55 (46, 65) | 0.007 |
| Alanine aminotransferase (U/L) | 23 (19, 39.5) | 21 (17, 27) | 0.019 |
| Aspartate aminotransferase (U/L) | 32 (23.5, 50) | 27 (23, 34) | 0.001 |
| Gamma-glutamyl transferase (U/L) | 74 (41, 151) | 60.6 (36.5, 111) | 0.065 |
| Alkaline phosphatase (U/L) | 106 (80.6, 142) | 90 (72, 117) | 0.006 |
| Total protein (g/L) | 61.1 (54.1, 66.9) | 63.2 (58.7, 67.8) | 0.018 |
| Albumin (g/L) | 33.2 (28.7, 39.8) | 38.3 (34, 42) | < 0.001 |
| Total bilirubin (µmol/L) | 26.5 (14.8, 60.2) | 21 (14.1, 31.5) | 0.015 |
| Prothrombin time (s) | 16.3 (14.7, 18.5) | 14.6 (13.7, 16.0) | < 0.001 |
Table 2 Comparison of patient characteristics between the training and validation cohorts
| Variables | Training cohort (n = 334) | Validation cohort (n = 110) | P value |
| Age (years) | 51.4 ± 11.1 | 51.9 ± 10.3 | 0.663 |
| Sex (male) | 193 (57.8) | 66 (60) | 0.683 |
| Diabetes | 26 (7.8) | 6 (5.5) | 0.412 |
| Ascites | 131 (39.2) | 46 (41.8) | 0.630 |
| Hepatic encephalopathy | 10 (3) | 3 (2.7) | 1 |
| IVC or HV thrombosis | 60 (18) | 28 (25.5) | 0.087 |
| Portal vein thrombosis | 20 (6) | 3 (2.7) | 0.181 |
| Spleen thickness (mm) | 45 (39, 49) | 43 (38, 51) | 0.700 |
| Portal vein diameter (mm) | 12.7 (10.2, 14.6) | 12.7 (10, 15) | 0.763 |
| BCS type | 0.389 | ||
| HV type | 69 (20.6) | 17 (15.5) | |
| Mixed type | 227 (68) | 77 (70) | |
| IVC type | 38 (11.4) | 16 (14.5) | |
| Child-Pugh grade | 0.683 | ||
| A | 210 (62.9) | 72 (65.4) | |
| B | 110 (32.9) | 32 (29.1) | |
| C | 14 (4.2) | 6 (5.5) | |
| ALBI, median (IQR) | -2.34 (-2.74, -1.89) | -2.31 (-2.64, -1.85) | 0.494 |
| MELD, median (IQR) | 4.74 (2.18, 8.00) | 4.14 (1.60, 7.34) | 0.252 |
| Use of anticoagulant medication | 271 (81.1) | 73 (66.4) | 0.001 |
| Invasive treatment to relieve hepatic venous outflow obstruction | 276 (82.6) | 95 (86.4) | 0.360 |
| White blood cell (× 109/L) | 3.4 (2.7, 4.4) | 3.7 (2.7, 5.0) | 0.107 |
| Red blood cell (× 1012/L) | 4.0 (3.5, 4.4) | 4 (3.6, 4.6) | 0.145 |
| Hemoglobin (g/L) | 122 (105, 136) | 124 (106, 140.3) | 0.358 |
| Platelet (× 109/L) | 86 (65, 118.3) | 91 (67, 141) | 0.434 |
| Sodium (mmol/L) | 142 (140, 143.5) | 142 (140, 143.3) | 0.677 |
| Creatinine (µmol/L) | 56 (47, 67) | 55 (44, 65.3) | 0.251 |
| Alanine aminotransferase (U/L) | 22 (17, 27.2) | 19.7 (15.6, 29.1) | 0.126 |
| Aspartate aminotransferase (U/L) | 28 (23, 35) | 27.3 (21.7, 34.5) | 0.357 |
| Gamma-glutamyl transferase (U/L) | 61 (35.8, 117) | 64.2 (45.0, 111.6) | 0.272 |
| Alkaline phosphatase (U/L) | 92 (72, 121.3) | 96.4 (79, 127.3) | 0.273 |
| Total protein (g/L) | 63.2 (58.5, 67.7) | 62.6 (57.6, 67.6) | 0.526 |
| Albumin (g/L) | 38 (33.3, 41.8) | 37.7 (33.3, 41.3) | 0.672 |
| Total bilirubin (µmol/L) | 21 (13.9, 33.4) | 22.8 (15.1, 35.4) | 0.536 |
| Prothrombin time (s) | 14.8 (13.8, 16.4) | 14.6 (13.2, 16.1) | 0.064 |
Table 3 Univariate and multivariate analyses of factors associated with gastroesophageal variceal bleeding in patients with Budd-Chiari syndrome and gastroesophageal varices
| Variables | Univariate cox regression | Multivariate cox regression | ||
| HR (95%CI) | P value | HR (95%CI) | P value | |
| Age | 0.994 (0.968-1.020) | 0.646 | ||
| Sex | 3.621 (1.686-7.777) | 0.001 | ||
| Hepatic encephalopathy | 0.712 (0.098-5.166) | 0.737 | ||
| Diabetes | 0.535 (0.130-2.209) | 0.388 | ||
| Portal vein thrombosis | 3.329 (1.486-7.460) | 0.003 | ||
| IVC or HV thrombosis | 0.696 (0.295-1.645) | 0.409 | ||
| Invasive treatment to relieve hepatic venous outflow obstruction | 0.127 (0.070-0.230) | < 0.001 | 0.123 (0.048-0.318) | <0.001 |
| Use of anticoagulant medication | 3.408 (1.056-10.994) | 0.040 | 8.905 (2.296-34.534) | 0.002 |
| Ascites | 1.798 (1.001-3.229) | 0.050 | ||
| Portal vein diameter (mm) | 1.003 (0.915-1.099) | 0.953 | ||
| Spleen thickness (mm) | 1.041 (1.015-1.068) | 0.002 | ||
| White blood cell (× 109/L) | 1.071 (0.946-1.221) | 0.271 | ||
| Red blood cell (× 1012/L) | 0.563 (0.388-0.818) | 0.003 | ||
| Hemoglobin (g/L) | 0.976 (0.965-0.986) | < 0.001 | 0.974 (0.955-0.994) | 0.012 |
| Platelet (× 109/L) | 0.988 (0.979-0.997) | 0.006 | ||
| Sodium (mmol/L) | 0.828 (0.773-0.887) | < 0.001 | ||
| Creatinine (µmol/L) | 1.025 (1.014-1.037) | < 0.001 | ||
| Aspartate aminotransferase (U/L) | 1.009 (1.001-1.017) | 0.020 | ||
| Gamma-glutamyl transferase (U/L) | 1.000 (0.998-1.002) | 0.864 | ||
| Alkaline phosphatase (U/L) | 1.004 (1.002-1.007) | 0.002 | ||
| Albumin | 0.899 (0.861-0.939) | < 0.001 | ||
| Direct bilirubin | 1.012 (1.007-1.016) | < 0.001 | ||
| Prothrombin time | 1.080 (1.047-1.113) | < 0.001 | ||
| BCS type | 0.081 | |||
| Mixed type vs HV type | 0.501 (0.265-0.945) | 0.033 | ||
| IVC type vs HV type | 0.450 (0.149-1.355) | 0.156 | ||
| Child | < 0.001 | |||
| B vs A | 1.408 (0.706-2.808) | 0.311 | ||
| C vs A | 14.353 (6.881-29.937) | < 0.001 | ||
Table 4 C-indices of various models
| Variables | Training cohort | Validation cohort | ||||
| C-index (95%CI) | AIC | P value | C-index (95%CI) | AIC | P value | |
| R + C model | 0.906 (0.864-0.947) | 407.267 | - | 0.859 (0.761-0.958) | 112.684 | - |
| R model | 0.825 (0.761-0.889) | 474.138 | 0.006 | 0.706 (0.566-0.846) | 142.004 | 0.015 |
| C model | 0.802 (0.724-0.879) | 442.580 | 0.003 | 0.699 (0.539-0.859) | 136.163 | 0.035 |
| MELD | 0.721 (0.646-0.796) | 481.666 | < 0.001 | 0.635 (0.485-0.786) | 147.129 | 0.002 |
| ALBI | 0.667 (0.581-0.753) | 490.816 | < 0.001 | 0.634 (0.491-0.776) | 147.705 | 0.004 |
- Citation: Wang ZD, Nan HJ, Li SX, Li LH, Liu ZC, Guo HH, Li L, Liu SY, Li H, Bai YL, Dang XW. Development and validation of a radiomics-based prediction model for variceal bleeding in patients with Budd-Chiari syndrome-related gastroesophageal varices. World J Gastroenterol 2025; 31(19): 104563
- URL: https://www.wjgnet.com/1007-9327/full/v31/i19/104563.htm
- DOI: https://dx.doi.org/10.3748/wjg.v31.i19.104563