Hepatic encephalopathy (HE), one of the most common complications of liver cirrhosis, is defined as a brain dysfunction. This developed model could potentially improve the early detection of HE with high mortality, subsequently improving clinical outcomes in these patients with HE, but further external prospective validation is still required. In this study, the NNET model demonstrated better discrimination in predicting 28-day mortality as compared to other models. Additionally, the performance of the NNET is superior to existing scores, including Model for End-Stage Liver Disease (MELD) and Model for End-Stage Liver Disease-Sodium (MELD-Na). Furthermore, in the calibration curve, the NNET model was also well-calibrated ( P = 0.323), which means that it can better predict the 28-day mortality in HE patients. Validation set indicated that the artificial neural network (NNET) model had the highest AUC of 0.837 (95% CI:0.774–0.901). Acute physiology score III (APSIII), sepsis related organ failure assessment (SOFA), international normalized ratio (INR), total bilirubin (TBIL), albumin, blood urea nitrogen (BUN), acute kidney injury (AKI) and mechanical ventilation were identified as independent risk factors. Of these, 112 (18.64%) experienced death within 28 days. In the MIMIC-IV database, 601 patients were eventually diagnosed with HE. The area under the curve (AUC) and calibration curve were used to determine the predictive performance of different ML models. Predictors were identified by recursive feature elimination (RFE) within 24 h of intensive care unit (ICU) admission. The outcome was defined as 28-day mortality. Training cohort was used for establishing the model while validation cohort was used for validation. Patients from MIMIC-IV were randomized into training and validation cohorts in a ratio of 7:3. MethodsĪ retrospective cohort study was conducted in the Medical Information Mart for Intensive Care (MIMIC)-IV database. This study aimed to develop and validate machine learning (ML) models to predict 28-day mortality for patients with HE. These patients have the highest priority to receive an organ and are not affected by the MELD system.Hepatic encephalopathy (HE) is associated with marked increases in morbidity and mortality for cirrhosis patients. This will help ensure that livers go to the sickest patient, that is the person in greatest need at that time.Ĭategory 1 and 2 patients have acute liver failure and a very short life expectancy without a transplant. Your MELD score will be assessed monthly whilst you are on the waiting list. A patient’s MELD score may go up or down over time depending on the status of his or her liver disease. The majority of patients waiting for a liver transplantation have chronic liver disease and are listed as Category 3 and have their MELD score calculated regularly. Poor kidney function is often associated with severe liver disease. Creatinine, which measures kidney function.INR, prothrombin time, which measures the liver’s ability to make blood clotting factors and.
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