12-Month Albumin and Platelets Predict Recompensation in Hepatitis B Cirrhosis with Ascites as the First Decompensation
DOI:
https://doi.org/10.71222/efgn0866Keywords:
HBV-related cirrhosis, prognostic model, recompensation, albumin, plateletsAbstract
Background and objective: Recompensation is a key point in the course of decompensated cirrhosis. Previous studies have focused on the prognostic factors at decompensation onset, but the determinants of the relatively stable stage after virus inhibition are not clear. The purpose of this study was to identify the prognostic factors for recompensation in hepatitis B virus (HBV) cirrhosis patients with ascites as the first decompensating event under regular antiviral therapy. Methods: This double-center retrospective cohort study included all HBV-related cirrhosis patients with ascites for the first time, regardless of previous antiviral treatment history, all patients received nucleos(t)ide analogues (NAs) treatment. Cox regression analysis was performed 12 months after decompensation (at this time, 93.6% of patients achieved virological inhibition), and independent predictive factors were identified. A prognosis model was constructed. The performance of the model was evaluated by bootstrap verification, time-dependent receiver operating characteristic (ROC) curve, and decision curve analysis Results: During the median follow-up of 23.7 months, 48 patients (34.3%) achieved recompensation. Albumin (ALB) and platelet count (PLT) at 12 months after decompensation were the only independent predictors. The model showed excellent discrimination ability (C index=0.798), and the decision curve analysis showed that its clinical net benefit was significantly better than the traditional model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score. Conclusions: This study confirmed that 12-month ALB and PLT can predict the compensatory recovery of HBV-related cirrhosis with ascites after the first decompensation. The validation in different populations will establish its wider clinical application value.
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