Development and Validation of a Model Consisting of Comorbidity Burden to Calculate Risk of Death Within 6 Months for Patients With Suspected Drug-Induced Liver Injury
Patients with drug-induced liver injury (DILI) frequently have comorbid conditions, but the effects of non-liver comorbidities on outcomes are not well understood. We investigated the association between comorbidity burden and outcomes of patients with DILI, and developed and validated a model to ca...
Gespeichert in:
| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 2019-11, Vol.157 (5), p.1245-1252.e3 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1252.e3 |
|---|---|
| container_issue | 5 |
| container_start_page | 1245 |
| container_title | Gastroenterology (New York, N.Y. 1943) |
| container_volume | 157 |
| creator | Ghabril, Marwan Gu, Jiezhun Yoder, Lindsay Corbito, Laura Ringel, Amit Beyer, Christian D. Vuppalanchi, Raj Barnhart, Huiman Hayashi, Paul H. Chalasani, Naga |
| description | Patients with drug-induced liver injury (DILI) frequently have comorbid conditions, but the effects of non-liver comorbidities on outcomes are not well understood. We investigated the association between comorbidity burden and outcomes of patients with DILI, and developed and validated a model to calculate risk of death within 6 months.
A multiple logistic regression model identified variables independently associated with death within 6 months of presenting with suspected DILI (6-month mortality) for 306 patients enrolled in the Drug-Induced Liver Injury Network prospective study at Indiana University (discovery cohort). The model was validated using data from 247 patients with suspected DILI enrolled in the same study at the University of North Carolina (validation cohort). Medical comorbidity burden was calculated using the Charlson Comorbidity Index—patients with scores higher than 2 were considered to have significant comorbidities.
Six-month mortality was 8.5% in the discovery cohort and 4.5% in the validation cohort. In the discovery cohort, significant comorbidities (odds ratio, 5.4; 95% confidence interval [CI], 2.1–13.8), Model for End-Stage Liver Disease score (odds ratio, 1.11; 95% CI, 1.04–1.17), and serum level of albumin at presentation (odds ratio, 0.39; 95% CI, 0.2–0.76) were independently associated with 6-month mortality. A model based on these 3 variables identified patients who died within 6 months, with c-statistic values of 0.89 (95% CI, 0.86–0.94) in the discovery cohort and 0.91 (95% CI, 0.83–0.99) in the validation cohort. We developed a web-based calculator for use in the clinic to determine risk of death within 6 months for patients with suspected DILI.
We developed and validated a model based on comorbidity burden, Model for End-Stage Liver Disease score, and serum level of albumin that predicts 6-month mortality in patients with suspected DILI. |
| doi_str_mv | 10.1053/j.gastro.2019.07.006 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6815697</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0016508519410858</els_id><sourcerecordid>31302142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c463t-fff438d7a863cf326084b77d20d803e479715f5b002a1c63cee92db6076da2a3</originalsourceid><addsrcrecordid>eNp9UdGO0zAQtBCI6x38AUL-gYS1nTjJCxKkwFUqAsEJHi0ntluX1K5sp1K_iN_EpXDAC08re3dmdmcQekagJFCzF7tyI2MKvqRAuhKaEoA_QAtS07YAIPQhWuTCixra-gpdx7gDgI615DG6YoQBJRVdoO9LfdSTP-y1S1g6hb_IySqZrHfYGyzxe6_0hHvvoo3Jus35t_d7HwarbDrh13NQ2uHkcS-ncZ5k0viTjd_Oc0st0xZ_tWlrHeaZyqVtxMYH_DErZMX4s4k_z_Ggx6QVXoZ5U6ycmsf8WNujDnjldnM4PUGPjJyifvqr3qC7t2_u-tti_eHdqn-1LsaKs1QYYyrWqka2nI2GUQ5tNTSNoqBaYLpquobUph4AqCRjntG6o2rg0HAlqWQ36OWF9jAPe63GvGOQkzgEu5fhJLy04t-Os1ux8UfBW1LzrskE1YVgDD7GoM09loA45yZ24pKbOOcmoBE5twx7_rfuPeh3UH8W0_n4o9VBxDE7mG2yIVsnlLf_V_gBvKGvXQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Development and Validation of a Model Consisting of Comorbidity Burden to Calculate Risk of Death Within 6 Months for Patients With Suspected Drug-Induced Liver Injury</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>Alma/SFX Local Collection</source><creator>Ghabril, Marwan ; Gu, Jiezhun ; Yoder, Lindsay ; Corbito, Laura ; Ringel, Amit ; Beyer, Christian D. ; Vuppalanchi, Raj ; Barnhart, Huiman ; Hayashi, Paul H. ; Chalasani, Naga</creator><creatorcontrib>Ghabril, Marwan ; Gu, Jiezhun ; Yoder, Lindsay ; Corbito, Laura ; Ringel, Amit ; Beyer, Christian D. ; Vuppalanchi, Raj ; Barnhart, Huiman ; Hayashi, Paul H. ; Chalasani, Naga</creatorcontrib><description>Patients with drug-induced liver injury (DILI) frequently have comorbid conditions, but the effects of non-liver comorbidities on outcomes are not well understood. We investigated the association between comorbidity burden and outcomes of patients with DILI, and developed and validated a model to calculate risk of death within 6 months.
A multiple logistic regression model identified variables independently associated with death within 6 months of presenting with suspected DILI (6-month mortality) for 306 patients enrolled in the Drug-Induced Liver Injury Network prospective study at Indiana University (discovery cohort). The model was validated using data from 247 patients with suspected DILI enrolled in the same study at the University of North Carolina (validation cohort). Medical comorbidity burden was calculated using the Charlson Comorbidity Index—patients with scores higher than 2 were considered to have significant comorbidities.
Six-month mortality was 8.5% in the discovery cohort and 4.5% in the validation cohort. In the discovery cohort, significant comorbidities (odds ratio, 5.4; 95% confidence interval [CI], 2.1–13.8), Model for End-Stage Liver Disease score (odds ratio, 1.11; 95% CI, 1.04–1.17), and serum level of albumin at presentation (odds ratio, 0.39; 95% CI, 0.2–0.76) were independently associated with 6-month mortality. A model based on these 3 variables identified patients who died within 6 months, with c-statistic values of 0.89 (95% CI, 0.86–0.94) in the discovery cohort and 0.91 (95% CI, 0.83–0.99) in the validation cohort. We developed a web-based calculator for use in the clinic to determine risk of death within 6 months for patients with suspected DILI.
We developed and validated a model based on comorbidity burden, Model for End-Stage Liver Disease score, and serum level of albumin that predicts 6-month mortality in patients with suspected DILI.</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1053/j.gastro.2019.07.006</identifier><identifier>PMID: 31302142</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Cause of Death ; CCI ; Chemical and Drug Induced Liver Injury - diagnosis ; Chemical and Drug Induced Liver Injury - mortality ; Chemical and Drug Induced Liver Injury - therapy ; Comorbidity ; DILIN Prospective Study ; Female ; Health Status ; Health Status Indicators ; Humans ; Male ; MELD ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Reproducibility of Results ; Risk Assessment ; Risk Factors ; Time Factors</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 2019-11, Vol.157 (5), p.1245-1252.e3</ispartof><rights>2019 AGA Institute</rights><rights>Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-fff438d7a863cf326084b77d20d803e479715f5b002a1c63cee92db6076da2a3</citedby><cites>FETCH-LOGICAL-c463t-fff438d7a863cf326084b77d20d803e479715f5b002a1c63cee92db6076da2a3</cites><orcidid>0000-0002-1239-8648</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.gastro.2019.07.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31302142$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghabril, Marwan</creatorcontrib><creatorcontrib>Gu, Jiezhun</creatorcontrib><creatorcontrib>Yoder, Lindsay</creatorcontrib><creatorcontrib>Corbito, Laura</creatorcontrib><creatorcontrib>Ringel, Amit</creatorcontrib><creatorcontrib>Beyer, Christian D.</creatorcontrib><creatorcontrib>Vuppalanchi, Raj</creatorcontrib><creatorcontrib>Barnhart, Huiman</creatorcontrib><creatorcontrib>Hayashi, Paul H.</creatorcontrib><creatorcontrib>Chalasani, Naga</creatorcontrib><title>Development and Validation of a Model Consisting of Comorbidity Burden to Calculate Risk of Death Within 6 Months for Patients With Suspected Drug-Induced Liver Injury</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>Patients with drug-induced liver injury (DILI) frequently have comorbid conditions, but the effects of non-liver comorbidities on outcomes are not well understood. We investigated the association between comorbidity burden and outcomes of patients with DILI, and developed and validated a model to calculate risk of death within 6 months.
A multiple logistic regression model identified variables independently associated with death within 6 months of presenting with suspected DILI (6-month mortality) for 306 patients enrolled in the Drug-Induced Liver Injury Network prospective study at Indiana University (discovery cohort). The model was validated using data from 247 patients with suspected DILI enrolled in the same study at the University of North Carolina (validation cohort). Medical comorbidity burden was calculated using the Charlson Comorbidity Index—patients with scores higher than 2 were considered to have significant comorbidities.
Six-month mortality was 8.5% in the discovery cohort and 4.5% in the validation cohort. In the discovery cohort, significant comorbidities (odds ratio, 5.4; 95% confidence interval [CI], 2.1–13.8), Model for End-Stage Liver Disease score (odds ratio, 1.11; 95% CI, 1.04–1.17), and serum level of albumin at presentation (odds ratio, 0.39; 95% CI, 0.2–0.76) were independently associated with 6-month mortality. A model based on these 3 variables identified patients who died within 6 months, with c-statistic values of 0.89 (95% CI, 0.86–0.94) in the discovery cohort and 0.91 (95% CI, 0.83–0.99) in the validation cohort. We developed a web-based calculator for use in the clinic to determine risk of death within 6 months for patients with suspected DILI.
We developed and validated a model based on comorbidity burden, Model for End-Stage Liver Disease score, and serum level of albumin that predicts 6-month mortality in patients with suspected DILI.</description><subject>Adult</subject><subject>Aged</subject><subject>Cause of Death</subject><subject>CCI</subject><subject>Chemical and Drug Induced Liver Injury - diagnosis</subject><subject>Chemical and Drug Induced Liver Injury - mortality</subject><subject>Chemical and Drug Induced Liver Injury - therapy</subject><subject>Comorbidity</subject><subject>DILIN Prospective Study</subject><subject>Female</subject><subject>Health Status</subject><subject>Health Status Indicators</subject><subject>Humans</subject><subject>Male</subject><subject>MELD</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UdGO0zAQtBCI6x38AUL-gYS1nTjJCxKkwFUqAsEJHi0ntluX1K5sp1K_iN_EpXDAC08re3dmdmcQekagJFCzF7tyI2MKvqRAuhKaEoA_QAtS07YAIPQhWuTCixra-gpdx7gDgI615DG6YoQBJRVdoO9LfdSTP-y1S1g6hb_IySqZrHfYGyzxe6_0hHvvoo3Jus35t_d7HwarbDrh13NQ2uHkcS-ncZ5k0viTjd_Oc0st0xZ_tWlrHeaZyqVtxMYH_DErZMX4s4k_z_Ggx6QVXoZ5U6ycmsf8WNujDnjldnM4PUGPjJyifvqr3qC7t2_u-tti_eHdqn-1LsaKs1QYYyrWqka2nI2GUQ5tNTSNoqBaYLpquobUph4AqCRjntG6o2rg0HAlqWQ36OWF9jAPe63GvGOQkzgEu5fhJLy04t-Os1ux8UfBW1LzrskE1YVgDD7GoM09loA45yZ24pKbOOcmoBE5twx7_rfuPeh3UH8W0_n4o9VBxDE7mG2yIVsnlLf_V_gBvKGvXQ</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Ghabril, Marwan</creator><creator>Gu, Jiezhun</creator><creator>Yoder, Lindsay</creator><creator>Corbito, Laura</creator><creator>Ringel, Amit</creator><creator>Beyer, Christian D.</creator><creator>Vuppalanchi, Raj</creator><creator>Barnhart, Huiman</creator><creator>Hayashi, Paul H.</creator><creator>Chalasani, Naga</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1239-8648</orcidid></search><sort><creationdate>20191101</creationdate><title>Development and Validation of a Model Consisting of Comorbidity Burden to Calculate Risk of Death Within 6 Months for Patients With Suspected Drug-Induced Liver Injury</title><author>Ghabril, Marwan ; Gu, Jiezhun ; Yoder, Lindsay ; Corbito, Laura ; Ringel, Amit ; Beyer, Christian D. ; Vuppalanchi, Raj ; Barnhart, Huiman ; Hayashi, Paul H. ; Chalasani, Naga</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-fff438d7a863cf326084b77d20d803e479715f5b002a1c63cee92db6076da2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cause of Death</topic><topic>CCI</topic><topic>Chemical and Drug Induced Liver Injury - diagnosis</topic><topic>Chemical and Drug Induced Liver Injury - mortality</topic><topic>Chemical and Drug Induced Liver Injury - therapy</topic><topic>Comorbidity</topic><topic>DILIN Prospective Study</topic><topic>Female</topic><topic>Health Status</topic><topic>Health Status Indicators</topic><topic>Humans</topic><topic>Male</topic><topic>MELD</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghabril, Marwan</creatorcontrib><creatorcontrib>Gu, Jiezhun</creatorcontrib><creatorcontrib>Yoder, Lindsay</creatorcontrib><creatorcontrib>Corbito, Laura</creatorcontrib><creatorcontrib>Ringel, Amit</creatorcontrib><creatorcontrib>Beyer, Christian D.</creatorcontrib><creatorcontrib>Vuppalanchi, Raj</creatorcontrib><creatorcontrib>Barnhart, Huiman</creatorcontrib><creatorcontrib>Hayashi, Paul H.</creatorcontrib><creatorcontrib>Chalasani, Naga</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghabril, Marwan</au><au>Gu, Jiezhun</au><au>Yoder, Lindsay</au><au>Corbito, Laura</au><au>Ringel, Amit</au><au>Beyer, Christian D.</au><au>Vuppalanchi, Raj</au><au>Barnhart, Huiman</au><au>Hayashi, Paul H.</au><au>Chalasani, Naga</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and Validation of a Model Consisting of Comorbidity Burden to Calculate Risk of Death Within 6 Months for Patients With Suspected Drug-Induced Liver Injury</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>157</volume><issue>5</issue><spage>1245</spage><epage>1252.e3</epage><pages>1245-1252.e3</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><abstract>Patients with drug-induced liver injury (DILI) frequently have comorbid conditions, but the effects of non-liver comorbidities on outcomes are not well understood. We investigated the association between comorbidity burden and outcomes of patients with DILI, and developed and validated a model to calculate risk of death within 6 months.
A multiple logistic regression model identified variables independently associated with death within 6 months of presenting with suspected DILI (6-month mortality) for 306 patients enrolled in the Drug-Induced Liver Injury Network prospective study at Indiana University (discovery cohort). The model was validated using data from 247 patients with suspected DILI enrolled in the same study at the University of North Carolina (validation cohort). Medical comorbidity burden was calculated using the Charlson Comorbidity Index—patients with scores higher than 2 were considered to have significant comorbidities.
Six-month mortality was 8.5% in the discovery cohort and 4.5% in the validation cohort. In the discovery cohort, significant comorbidities (odds ratio, 5.4; 95% confidence interval [CI], 2.1–13.8), Model for End-Stage Liver Disease score (odds ratio, 1.11; 95% CI, 1.04–1.17), and serum level of albumin at presentation (odds ratio, 0.39; 95% CI, 0.2–0.76) were independently associated with 6-month mortality. A model based on these 3 variables identified patients who died within 6 months, with c-statistic values of 0.89 (95% CI, 0.86–0.94) in the discovery cohort and 0.91 (95% CI, 0.83–0.99) in the validation cohort. We developed a web-based calculator for use in the clinic to determine risk of death within 6 months for patients with suspected DILI.
We developed and validated a model based on comorbidity burden, Model for End-Stage Liver Disease score, and serum level of albumin that predicts 6-month mortality in patients with suspected DILI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31302142</pmid><doi>10.1053/j.gastro.2019.07.006</doi><orcidid>https://orcid.org/0000-0002-1239-8648</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0016-5085 |
| ispartof | Gastroenterology (New York, N.Y. 1943), 2019-11, Vol.157 (5), p.1245-1252.e3 |
| issn | 0016-5085 1528-0012 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6815697 |
| source | MEDLINE; Access via ScienceDirect (Elsevier); Alma/SFX Local Collection |
| subjects | Adult Aged Cause of Death CCI Chemical and Drug Induced Liver Injury - diagnosis Chemical and Drug Induced Liver Injury - mortality Chemical and Drug Induced Liver Injury - therapy Comorbidity DILIN Prospective Study Female Health Status Health Status Indicators Humans Male MELD Middle Aged Predictive Value of Tests Prognosis Prospective Studies Reproducibility of Results Risk Assessment Risk Factors Time Factors |
| title | Development and Validation of a Model Consisting of Comorbidity Burden to Calculate Risk of Death Within 6 Months for Patients With Suspected Drug-Induced Liver Injury |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-17T05%3A36%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Development%20and%20Validation%20of%20a%20Model%20Consisting%20of%20Comorbidity%20Burden%20to%20Calculate%20Risk%20of%20Death%20Within%206%20Months%20for%20Patients%20With%20Suspected%20Drug-Induced%20Liver%20Injury&rft.jtitle=Gastroenterology%20(New%20York,%20N.Y.%201943)&rft.au=Ghabril,%20Marwan&rft.date=2019-11-01&rft.volume=157&rft.issue=5&rft.spage=1245&rft.epage=1252.e3&rft.pages=1245-1252.e3&rft.issn=0016-5085&rft.eissn=1528-0012&rft_id=info:doi/10.1053/j.gastro.2019.07.006&rft_dat=%3Cpubmed_cross%3E31302142%3C/pubmed_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/31302142&rft_els_id=S0016508519410858&rfr_iscdi=true |