Establishment of Nomograph Model Based on NLR to Predict the Risk of Portal Vein Thrombosis in Liver Cirrhosis
Objective To analyze the risk factors of portal vein thrombosis(PVT)in liver cirrhosis,and to construct a relevant nomogram model to predict the risk of PVT in liver cirrhosis.Methods The clinical data of 1000 patients with liver cirrhosis who were hospitalized in our hospital from January 2014 to October 2021 were retrospectively analyzed.The patients admitted before December 2020 were set as the modeling set(n=810),and the patients admitted after December 2020 were set as the validation set(n=190).In the modeling set,the patients were divided into PVT group(259 patients)and N-PVT group(551 patients)according to whether there was portal vein thrombosis.Multivariate logistic regression analysis was used to screen out the independent risk factors of PVT formation in liver cirrhosis,focusing on the correlation between neutrophil-to-lymphocyte ratio(NLR)and PVT formation in liver cirrhosis.Based on NLR,a nomogram model was constructed to predict the risk of PVT formation in liver cirrhosis,and the model was verified internally and externally.Results The proportion of splenectomy history,PLT,MPV,NLR,MLR,PLR,portal vein diameter and splenic vein diameter in PVT group were higher than those in N-PVT group(P＜0.05).There was no significant difference in age,gender,Child-Pugh classification,albumin and history of diabetes between the two groups(P＞0.05).Multivariate Logistic regression analysis showed that splenectomy history,NLR,main portal vein diameter and splenic vein diameter were independent predictors of PVT formation in patients with cirrhosis(P＜0.05).For each unit increase in NLR,the risk of PVT formation in patients with cirrhosis increased by 0.527 times(OR=1.527,95％CI:1.373-1.698,P=0.000).A nomogram model for predicting PVT formation in liver cirrhosis was constructed based on the history of splenectomy,NLR,portal vein diameter and splenic vein diameter.The calibration curve of the nomogram model showed that the predicted values of PVT formation in patients with cirrhosis in the modeling set and the validation set were in good agreement with the actual observed values(P＞0.05).The area under the ROC curve(AUC)was 0.769(95％CI:0.732-0.805),and the AUC of the combined prediction of the validation set was 0.789(95％CI:0.712-0.866).The results of decision curve analysis showed that within most reasonable threshold probability ranges,the four indicators of splenectomy history,NLR,main portal vein diameter and splenic vein diameter in the modeling set and validation set had good net rate of return for predicting PVT formation in cirrhosis,and the overall net rate of return based on NLR combined with the other three indicators was higher than that based on a single indicator.Conclusion The nomogram model based on NLR can be used to accurately predict the risk of PVT in liver cirrhosis.
万方数据
维普
