SynthesisBMC gastroenterology2026
Risk prediction models for hepatic encephalopathy in patients with liver cirrhosis: a systematic review and meta-analysis.
Synthesis in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundTo conduct a systematic review and meta-analysis of existing prediction models for hepatic encephalopathy (HE) in patients with cirrhosis.
methodsFour Chinese and five English databases were searched for studies on prediction models for the risk of HE in cirrhosis from inception to April 12, 2025. Two researchers independently conducted the literature search and data extraction, and the quality of the literature was evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST). The meta-analysis was conducted using Review Manager 5.4 and Stata 17.0 software.
resultsThirty-eight best prediction models from thirty-eight studies were ultimately included in this review. Among them, 17 studies predicted HE after transjugular intrahepatic portosystemic shunt (TIPS). The incidence of HE ranged from 7.2% to 50.4%. The most commonly used predictors were age and Child–Pugh grade/score. The reported area under the curve (AUC) or c-statistic values ranged from 0.667 to 0.969. Thirty-four studies were found to have a high risk of bias, and 27 studies raised applicability concerns, primarily due to inappropriate data sources, limitations in the domain of analysis, and homogenous study populations. Four externally validated logistic regression models had a combined AUC of 0.802 (95% CI: 0.785—0.820), indicating moderate predictive performance. In meta-analysis, age (OR = 1.04, 95% CI: 1.03, 1.05), prior HE (OR = 4.42, 95% CI: 2.67, 7.31), low albumin (OR = 1.78, 95% CI: 1.25, 2.56), total bilirubin (OR = 2.22, 95% CI: 1.73, 2.85), Child–Pugh grade/score (OR = 2.41, 95% CI: 1.87, 3.09; OR = 1.65, 95% CI: 1.16, 2.33, respectively), ascites (OR = 1.96, 95% CI: 1.48, 2.60), and co-infection (OR = 2.57, 95% CI: 1.66, 3.98) were significant predictors of HE in cirrhosis (P < 0.01).
conclusionsPrediction models for estimating the risk of incident HE with cirrhosis demonstrate moderate discrimination performance, while with a high overall risk of bias and a lack of clinical effectiveness research. Future research should focus on developing new models through optimised study design and analysis, increased sample sizes, and external validation, and applying them to clinical practice.
trial registrationThe protocol for this review was registered on PROSPERO (CRD420251040913).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.