Prediction of risk of blood transfusion in patients with cirrhosis.

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY European Journal of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-01-28 DOI:10.1097/MEG.0000000000002904
Ying Li, Wenwen Zhu, Zhiqun Song, Wenbiao Liang, Xiaoyu Zhou
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Abstract

Background: Blood transfusion is usually required for cirrhotic patients with bleeding which is related to high risk of mortality. Identifying cirrhotic patients at high risk of bleeding and needing blood transfusions would benefit these patients, yet this remains an unmet need.

Objectives: This study aims to enhance blood transfusion management for patients with cirrhosis by developing a predictive model to assess the risk of transfusion.

Methods: We enrolled a cohort of 711 patients diagnosed with cirrhosis at The First Affiliated Hospital of Nanjing Medical University and divided into training set ( n  = 537) and validation set ( n  = 174). Each participant underwent a comprehensive clinical assessment. Data on prothrombin time (PT), platelet counts, and inflammatory markers were collected. Univariate and multivariate logistic regression analyses were performed to identify independent predictors. The nomogram was constructed. Model performance was evaluated through receiver operating characteristic curve analysis.

Results: The study successfully identified PT, platelet counts, and the mentioned inflammatory markers as significant predictors of the need for transfusion. The resulting nomogram demonstrated high predictive accuracy, with area under the curve values of 0.85 in the training set and 0.83 in the validation set.

Conclusion: The developed nomogram for predicting the need for blood transfusion in patients with cirrhosis shows promising effectiveness for clinical application. This tool can significantly contribute to optimizing transfusion practices, potentially improving patient care and outcomes through more personalized and efficient transfusion strategies.

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肝硬化患者输血风险的预测。
背景:肝硬化出血患者通常需要输血,这与高死亡率有关。识别出血高风险的肝硬化患者并需要输血将使这些患者受益,但这一需求仍未得到满足。目的:本研究旨在通过建立一个预测模型来评估输血风险,以加强肝硬化患者的输血管理。方法:纳入南京医科大学第一附属医院肝硬化患者711例,分为训练组(n = 537)和验证组(n = 174)。每位参与者都进行了全面的临床评估。收集凝血酶原时间(PT)、血小板计数和炎症标志物的数据。进行单变量和多变量逻辑回归分析以确定独立预测因子。构造了模态图。通过受试者工作特性曲线分析对模型性能进行评价。结果:该研究成功地确定了PT、血小板计数和上述炎症标志物作为输血需求的重要预测因素。得到的nomogram具有较高的预测精度,训练集的曲线下面积为0.85,验证集的曲线下面积为0.83。结论:建立的预测肝硬化患者输血需求的nomogram (nomogram)方法具有较好的临床应用价值。该工具可以显著有助于优化输血实践,通过更个性化和有效的输血策略,潜在地改善患者护理和结果。
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来源期刊
CiteScore
4.40
自引率
4.80%
发文量
269
审稿时长
1 months
期刊介绍: European Journal of Gastroenterology & Hepatology publishes papers reporting original clinical and scientific research which are of a high standard and which contribute to the advancement of knowledge in the field of gastroenterology and hepatology. The journal publishes three types of manuscript: in-depth reviews (by invitation only), full papers and case reports. Manuscripts submitted to the journal will be accepted on the understanding that the author has not previously submitted the paper to another journal or had the material published elsewhere. Authors are asked to disclose any affiliations, including financial, consultant, or institutional associations, that might lead to bias or a conflict of interest.
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