Clinical implications of a dynamic nomogram for predicting sepsis in acute liver failure

Table 1 Discrimination performance of the predictive models for sepsis risk in patients with acute liver failure in the internal derivation, internal validation, and external validation cohorts (area under receiver operating characteristic curve)

Cohort1	SIALF	SOFA	SIRS
Derivation (MIMIC-IV, n = 357)	0.849	0.733	0.578
Internal validation (n = 153)	0.847	0.746	0.653
External validation (FMCPH, n = 228)	0.835	0.721	0.615

¹Based on the principle of maximum Youden index, the optimal sepsis in acute liver failure cutoff was chosen at the threshold maximizing sensitivity + specificity - 1. The cohort-specific optima were 0.726 (derivation), 0.717 (internal validation), and 0.719 (external validation); for clinical interpretability we adopted a unified cutoff of 0.72.

MIMIC-IV: Medical Information Mart for Intensive Care IV; FMCPH: Fifth Medical Center of Chinese PLA General Hospital; SIALF: Sepsis in acute liver failure; SOFA: Sequential organ failure assessment; SIRI: Systemic inflammatory response syndrome.