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Discriminant function for prognostic indexes and probability of death in chronic severe hepatitis B
Wei-Min Ke1, Yi-Nong Ye, Shi Huang
1Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Shipai, Guangzhou, Guangdong Province 510630, P R China.
Insights
A new discriminant function accurately predicts survival in chronic severe hepatitis B (CSHB) patients. This tool uses key clinical factors to assess prognosis, aiding clinical decision-making for better patient outcomes.
Area of Science:
- Hepatology
- Internal Medicine
- Biostatistics
Background:
- Chronic severe hepatitis B (CSHB) poses significant prognostic challenges.
- Accurate prognosis assessment is crucial for managing CSHB patients.
Purpose of the Study:
- To develop a discriminant function for predicting prognosis in chronic severe hepatitis B.
- To utilize discriminant analysis for identifying key prognostic indicators.
Main Methods:
- Discriminant analysis was performed on 205 CSHB patients (101 survivors, 104 deaths).
- Key variables analyzed included serum total bilirubin, prothrombin activity, white blood cells, creatinine, ascites depth, hepatic encephalopathy, singultus, and digestive tract hemorrhage.
Main Results:
- A discriminant function (V) was established using the analyzed variables.
- The function demonstrated high accuracy: 92.3% for predicting death and 96.0% for predicting survival.
- Specific V values correlated with precise posterior probabilities of death, ranging from 0% to 100%.
Conclusions:
- The developed discriminant function offers an objective and practical method for assessing CSHB prognosis.
- This tool can aid clinicians in evaluating patient outcomes and guiding treatment strategies.
Background:
We aimed to determine a discriminant function for prognosis in chronic severe hepatitis B (CSHB), by discriminant analysis of prognostic indexes and probability of death.
Methods:
In 205 patients with chronic severe hepatitis B (101 patients in the survival group and 104 patients in the death group), we carried out discriminant analysis of serum total bilirubin, prothrombin activity, white blood cells, creatinine, maximum depth of ascites, hepatic encephalopathy, singultus, and digestive tract hemorrhage.
Results:
The discriminant function was V=0.00043 x total bilirubin (microM) - 0.025 x prothrombin activity (%) + 0.056 x white blood cells (10(9)/l) + 0.00284 x creatinine (microM) + 0.0014 x maximum depth of ascites (mm) + 0.724 x hepatic encephalopathy score + 0.078 x singultus score + 0.457 x digestive tract hemorrhage score - 2.488. The correctness of the function for predicting death in the death group was 92.3%, and that for predicting survival in the survival group was 96.0%. When the V values were -infinity, -4.595, -2.197, -1.386, -0.405, 0.405, 1.386, 2.197, 2.944, 4.595, and infinity, a posterior probabilities of death were 0%, 5%, 10%, 20%, 40%, 60%, 80%, 90%, 95%, 99%, and 100%, respectively.
Conclusions:
The discriminant function is an objective, convenient, and practical method to assess the prognosis of chronic severe hepatitis B.
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