Short-term prognostic factors for hepatitis B virus-related acute-on-chronic liver failure

Table 1 Demographic and clinical characteristics

	Survival group (n = 157)	Death group (n = 50)	P value
Age (yr)	40 (32, 48)	51(39, 55)	0.000
Gender (male, %)	130/157, 82.8	42/50, 84.0	0.844
Classification of liver failure (%)			0.006
A	116/157, 73.89	29/50, 58.00
B	92/157, 58.60	16/50, 32.00
C	2/157, 1.27	5/50, 10.00
Stage of liver failure (%)			0.000
Early	101/157, 64.33	5/50, 10.00
Middle	42/157, 26.75	13/50, 26.00
Late	14/157, 8.92	32/50, 64.00
Complications (%)
Pulmonary infection	39/157, 24.84	24/50, 48.00	0.003
Hepatic encephalopathy	10/157, 6.37	23/50, 46.00	0.000
Spontaneous bacterial peritonitis	10/157, 6.37	11/50, 22.00	0.005
Hepatorenal syndrome	0/157, 0	4/50, 8.00	0.003
Upper gastrointestinal hemorrhage	2/157, 1.27	6/50, 12.00	0.003
PLT (109/L)	128 (102, 154.50)	103 (87.50, 153)	0.044
ALB (g/dL)	3.28 ± 0.50	3.21 ± 0.53	0.381
Tbil (mg/dL)	13.55 (9.59, 19.88)	17.19 (12.36, 25.65)	0.011
ALT (U/L)	948.50 (400, 1984.7)	838.8 (331.40, 1705.78)	0.626
AST (U/L)	687.90 (273.85, 1258.50)	721.50 (252.50, 1554.35)	0.800
CHE (U/L)	4359 (3288, 5429)	3898 (2786.75, 5029.50)	0.197
Glu (mmol/L)	4.26 (3.65, 5.23)	4.64 (3.73, 5.75)	0.276
BUN (mg/dL)	9.08 (7.21, 12.30)	10.97 (8.42, 15.16)	0.014
Cr (mg/dL)	0.73 (0.61, 0.84)	0.76 (0.62, 0.94)	0.309
Na (mmol/L)	136.30 (134.30, 138.00)	135.22 (132.48, 138.33)	0.172
NLR	2.66 (1.89, 4.05)	4.00 (2.42, 6.43)	0.000
INR	1.83 (1.65, 2.13)	2.23 (1.93, 3.18)	0.000
HBsAg (log10IU/L)	3.70 (3.31, 3.91)	3.23 (2.65, 3.74)	0.001
HBeAg positive (%)	89/157 (56.70)	16/50 (32.00)	0.002
HBV-DNA (log10IU/L)	6.34 (5.14, 7.46)	6.39 (4.87, 7.82)	0.698
AFP (ng/mL)	63.15 (15.35, 204)	16.18 (6.79, 48.33)	0.000
GP73 (ng/mL)	237.92 (208.84, 309.79)	305.83 (215.32, 366.49)	0.003

AFP: Alpha-fetoprotein; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BUN: Blood urea nitrogen; CHE: Cholinesterase; Cr: Creatinine; Glu: Blood glucose; GP73: Golgi protein 73; HBV: Hepatitis B virus; INR: International normalized ratio; NLR: Neutrophil-to-lymphocyte ratio; PLT: Platelet count; Tbil: Total bilirubin.

Table 2 Cox regression analysis of factors affecting short-term prognosis in hepatitis B virus-related acute-on-chronic liver failure

	B	SE	Wald	HR	P value	95%CI
GP73 (ng/mL)	0.009	0.002	23.872	1.009	0.000	1.005-1.013
Stage of liver failure (middle)	1.621	0.529	9.373	5.056	0.002	1.792-14.269
Stage of liver failure (late)	3.106	0.490	401.135	22.335	0.000	8.544-58.388
Pulmonary infection	0.721	0.298	5.832	2.056	0.016	1.145-3.690
Hepatorenal syndrome	1.924	0.646	8.867	6.847	0.003	1.930-24.291
HBsAg	-0.371	0.140	6.998	0.690	0.008	0.524-0.908

CI: Confidence interval; GP73: Golgi protein 73; HR: Hazard ratio; SE: Standard error; B: Beta (Regression coefficient).

Table 3 Receiver operating characteristic curve analysis of the prognostic model

Prognostic model	Area under curve	95%CI	Sensitivity	Specificity	Youden’s index	Positive predictive value	Negative predictive value
MELD	0.699	0.631-0.761	0.652	0.543	0.196	31.24	82.80
MELD-Na	0.734	0.668-0.793	0.684	0.554	0.238	32.81	84.63
GP73-ACLF	0.916	0.870-0.950	0.816	0.597	0.413	39.20	91.06

ACLF: Acute-on-chronic liver failure; CI: Confidence interval; GP73: Golgi protein 73; MELD: Model for End-Stage Liver Disease.

Table 4 Comparison of prediction effectiveness between different prognostic models

Prognostic model	Difference in area	95%CI	Z	P value
GP73-ACLF vs MELD	0.217	0.122-0.312	4.487	< 0.0001
GP73-ACLF vs MELD-Na	0.183	0.087-0.278	3.746	0.0002
MELD vs MELD-Na	0.035	-0.018 to 0.087	1.286	0.198

ACLF: Acute-on-chronic liver failure; CI: Confidence interval; GP73: Golgi protein 73; MELD: Model for End-Stage Liver Disease.