Machine learning-based prediction models for liver-related events in patients with hepatitis B-related cirrhosis and clinically significant portal hypertension

Table 1 Baseline characteristics of patients with hepatitis B virus-related cirrhosis and clinically significant portal hypertension

	Overall (n = 576)	No LREs (n = 263)	LREs (n = 313)	P value
Age (year)	57 (51-62)	55 (48-60)	57 (51-62)	0.092
Sex of male	328 (56.9)	151 (57.4)	179 (57.2)	0.588
Follow-up time (year)	2.83 (1.42-4.25)	2.67 (1.46-4.50)	3.42 (1.42-4.25)	0.437
AST (U/L)	35.1 (26.6-52.0)	33.9 (26.4-49.7)	36.6 (26.6-52)	0.564
ALT (U/L)	30.5 (19.9-45.5)	31.2 (21.7-45.4)	29.3 (17.9-45.7)	0.183
TB (μmol/L)	21.05 (15.3-31.4)	18.5 (13.8-27.5)	23.2 (16.1-34)	< 0.001
DB (μmol/L)	8.65 (5.95-13.3)	7.2 (5.1-12.1)	9.5 (6.4-14.9)	< 0.001
ALB (g/L)	38.9 (29.9-44.8)	42.3 (35.5-46.5)	36.9 (28-42.3)	< 0.001
A/G	1.2 (0.8-1.5)	1.4 (1-1.6)	1.2 (0.8-1.4)	< 0.001
GGT (U/L)	39.9 (21.7-78.2)	38.5 (22-78.6)	41 (20.6-74.4)	0.852
ALP (U/L)	87.9 (65.4-116.9)	86.8 (66.0-111)	89.4 (65-121)	0.381
Bile acid (μmol/L)	19.6 (6.9-41.9)	10.9 (4.7-27.9)	31.5 (13.7-61.3)	< 0.001
Creatinine (μmol/L)	62.5 (52.5-72.4)	60.9 (51-71.1)	65.7 (54-76.3)	0.013
PT (second)	13.2 (12.4-14.4)	13.1 (12.4-14.5)	13.2 (12.4-14.4)	0.635
INR	1.22 (1.14-1.37)	1.19 (1.13-1.37)	1.26 (1.15-1.38)	0.003
WBC (× 109/L)	3.60 (2.66-4.84)	4.2 (3.1-5.34)	3.24 (2.37-4.36)	< 0.001
Neutrophil count (× 109/L)	1.94 (1.47-2.76)	2.28 (1.7-3.19)	1.81 (1.32-2.48)	< 0.001
Lymphocyte count (× 109/L)	1.10 (0.7-1.59)	1.29 (0.89-1.8)	0.91 (0.6-1.35)	< 0.001
HB (g/L)	134 (117-150)	142 (124-159)	129 (106-143)	< 0.001
PLT (× 109/L)	74 (52.8-99.6)	89 (65-117)	65 (45-89)	< 0.001
Child-Pugh score (point)	3 (3-5)	3 (3-3)	5 (4-6)	< 0.001
LSM (kPa)	25.4 (20.3-38)	22.5 (18.2-30.8)	30.6 (22-45)	< 0.001
LPR	0.37 (0.24-0.58)	0.27 (0.19-0.39)	0.49 (0.33-0.72)	< 0.001
LAR	0.71 (0.50-1.11)	0.56 (0.44, 1.83)	0.88 (0.60, 1.24)	< 0.001
LSPS	5.49 (3.19-9.03)	3.64 (2.51-6.19)	7.69 (4.68-11.36)	< 0.001
Portal vein width (mm)	12 (11-13)	12 (11-13)	12 (12-14)	< 0.001
Spleen thickness (mm)	44 (37-54)	42 (36-49)	48 (42-56)	< 0.001
Spleen diameter (cm)	14.8 (12.4-17.1)	13.8 (11.7-16.5)	15.4 (12.9-17.8)	< 0.001

Data are presented as median (IQR) for continuous variables and n (%) for categorical variables. Mann-Whitney U test was used for comparisons of continuous variables between groups; χ² test was used for categorical variables. LRE: Liver-related event; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; TB: Total bilirubin; DB: Direct bilirubin; ALB: Albumin; A/G: Albumin/globulin ratio; GGT: Gamma-glutamyltransferase; ALP: Alkaline phosphatase; PT: Prothrombin time; INR: International normalized ratio; WBC: White blood cell; HB: Hemoglobin; PLT: Platelet; LSM: Liver stiffness measurement; LPR: Liver stiffness measurement-to-platelet ratio; LAR: Liver stiffness measurement-to-albumin ratio; LSPS: Liver stiffness-spleen diameter-to-platelet ratio score.

Table 2 Performances of the machine learning models for predicting liver related events

Model	Accuracy	Recall	F1 score	Sensitivity	Specificity	PPV	NPV	AUC	CV-AUC
SVM	0.775	0.789	0.785	0.789	0.759	0.780	0.768	0.834	0.787 ± 0.060
RF	0.951	0.950	0.953	0.950	0.952	0.955	0.946	0.975	0.842 ± 0.045
LR	0.731	0.739	0.741	0.739	0.723	0.743	0.719	0.790	0.740 ± 0.055
XGBoost	0.951	0.950	0.953	0.950	0.952	0.955	0.946	0.965	0.830 ± 0.061
KNN	0.769	0.756	0.773	0.756	0.783	0.791	0.747	0.833	0.737 ± 0.045

PPV: Positive predictive value; NPV: Negative predictive value; AUC: Area under the receiver operating characteristic curve; CV: Cross-validation; SVM: Support vector machine; RF: Random forest; LR: Logistic regression; XGBoost: Extreme gradient boosting; KNN: K-nearest neighbor.