ArticleScientific reports2025
A novel prognostic model based on portal vein diameter for patients with acute-on-chronic liver failure.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The prompt and accurate prognostication of acute-on-chronic liver failure (ACLF) patients is crucial for clinical intervention and reducing mortality. This study aimed to develop a novel prognostic model based on pathological changes, with a specific focus on portal vein which is correlated with hepatic pathology. A cohort of 127 ACLF patients was enrolled to develop the prognostic model for 90-day mortality, which was validated in a prospective cohort of 105 ACLF patients. Demographic characteristics, laboratory indicators, and imaging factor portal vein diameter (PVD) were screened, and a nomogram prognostic model was developed using logistic regression. Patients with PVD ≥ 13.4 mm had significantly higher mortality (P = 0.047). PVD, age, neutrophil percentage, sex and total bilirubin were identified as independent predictors for the new PVD-based nomogram prognostic model, PANST. The C-index (0.878) of PANST score was higher than Chronic Liver Failure-Consortium-ACLF (CLIF-C ACLF), end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores (0.691, 0.687, 0.639, respectively; P < 0.001). The ROC and decision curves demonstrated that the PANST score was superior to CLIF-C ACLF, MELD and CTP scores. Furthermore, after subgroup analysis, the C-indices of PANST score for hepatitis B virus-related ACLF (HBV-ACLF) and non-HBV-ACLF patients (0.842,0.950) were significantly higher than those of CLIF-C ACLF score (0.772, 0.750; P < 0.05), MELD score (0.730, 0.608; all P < 0.05) and CTP score (0.701,0.513; all P < 0.05). These results were confirmed in the validation cohort. PVD was an independent predictor, and the PANST score, a novel prognostic model based on PVD can accurately predict 90-day mortality in ACLF patients.
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