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Updated: Oct 28, 2025

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Nomogram for hepatic venous pressure gradient in patients with cirrhosis
Li Li Zhou1,2, Guang Chuan Wang1, Ming Yan Zhang1
1Department of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China.
Objective:
The hepatic venous pressure gradient (HVPG) plays an important role in the treatment and prognosis of patients with cirrhosis. Our study aimed to develop and validate a nomogram for an HVPG >12 mmHg.
Methods:
A retrospective study was performed to create a nomogram for an HVPG >12 mmHg in a training cohort that was validated in another cohort. The discriminatory ability and calibration of the nomogram were tested using the C-statistic, area under the receiver operating characteristic curve (AUROC) and calibration plots.
Results:
The nomogram was based on portosystemic shunts identified on computed tomography images, the etiology of cirrhosis and the Child-Pugh grade. These parameters were significantly associated with an HVPG >12 mmHg (P < 0.05 for both the training and validation cohorts). In the training cohort, the model showed good discrimination (C-statistic, AUROC, and R2 of 0.71, 0.71 and 0.13, respectively) and good calibration. The total cutoff value was 112 and the sensitivity and specificity were 57.1% and 77.6%, respectively. The application of the nomogram in the validation cohort still yielded good discrimination (C-statistic 0.75 [95% confidence interval 0.61-0.89], AUROC 0.75, and R2 0.16) and good calibration.
Conclusions:
This nomogram is a convenient tool for predicting an HVPG >12 mmHg in patients with cirrhosis and can help clinicians quickly identify patients with decompensated cirrhosis.
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