Development and validation of a nomogram for predicting 28-day mortality in critically ill liver cirrhotic patients with coagulopathy
- 1Endoscopy Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005 China
- 2Endoscopy Center, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212 China
- 3Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, 350001 China
Abstract
Background: Although scoring systems exist to predict outcomes in patients with cirrhosis, specific systems for critically ill cirrhotic patients with coagulopathy are lacking. The aim of the study was to establish a reliable predictive model for 28-day mortality in cirrhotic patients with coagulopathy admitted to the intensive care unit.
Methods: The 880 cirrhotic patients with coagulopathy admitted to the intensive care unit from 2008 to 2022 in the Medical Information Mart for Intensive Care-IV database were randomly allocated to training (n = 616) and validation (n = 264) cohorts. Independent predictors of 28-day mortality were identified by logistic regression analysis and used to construct a nomogram.
Results: Age, white blood cell count, activated partial thromboplastin time, prothrombin time, total bilirubin level, blood lactate level, and blood bicarbonate level were identified as independent predictors of 28-day mortality. The nomogram showed good discrimination in the training (concordance index, 0.885; 95% confidence interval, 0.855–0.915) and validation (concordance index, 0.909; 95% confidence interval, 0.871–0.948) cohorts. Calibration, receiver operating characteristic, and clinical decision curves showed that the nomogram had good predictive ability.
Conclusions: The nomogram exhibited superior discernment and accuracy to SOFA, MELD3.0, ABIC scores and may help identify high-risk patients to allow early intervention and potentially improve clinical outcomes.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12876-026-05367-3.
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BibTeX
@article{lin2026development,
title = {{Development and validation of a nomogram for predicting 28-day mortality in critically ill liver cirrhotic patients with coagulopathy}},
author = {Yongxu Lin and Liqin Wei and Xujin Wei and Yuping Wang and Jiaxin Shen and Wenming Liu},
journal = {BMC Gastroenterology},
year = {2026},
month = sep,
doi = {10.1186/s12876-026-05367-3},
url = {https://doi.org/10.1186/s12876-026-05367-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Development and validation of a nomogram for predicting 28-day mortality in critically ill liver cirrhotic patients with coagulopathy
AU - Yongxu Lin
AU - Liqin Wei
AU - Xujin Wei
AU - Yuping Wang
AU - Jiaxin Shen
AU - Wenming Liu
PY - 2026
DA - 2026/09/01
JO - BMC Gastroenterology
DO - 10.1186/s12876-026-05367-3
UR - https://doi.org/10.1186/s12876-026-05367-3
AB - Background: Although scoring systems exist to predict outcomes in patients with cirrhosis, specific systems for critically ill cirrhotic patients with coagulopathy are lacking. The aim of the study was to establish a reliable predictive model for 28-day mortality in cirrhotic patients with coagulopathy admitted to the intensive care unit. Methods: The 880 cirrhotic patients with coagulopathy admitted to the intensive care unit from 2008 to 2022 in the Medical Information Mart for Intensive Care-IV database were randomly allocated to training (n = 616) and validation (n = 264) cohorts. Independent predictors of 28-day mortality were identified by logistic regression analysis and used to construct a nomogram. Results: Age, white blood cell count, activated partial thromboplastin time, prothrombin time, total bilirubin level, blood lactate level, and blood bicarbonate level were identified as independent predictors of 28-day mortality. The nomogram showed good discrimination in the training (concordance index, 0.885; 95% confidence interval, 0.855–0.915) and validation (concordance index, 0.909; 95% confidence interval, 0.871–0.948) cohorts. Calibration, receiver operating characteristic, and clinical decision curves showed that the nomogram had good predictive ability. Conclusions: The nomogram exhibited superior discernment and accuracy to SOFA, MELD3.0, ABIC scores and may help identify high-risk patients to allow early intervention and potentially improve clinical outcomes. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12876-026-05367-3.
SN - 1471-230X
ER -