Qi R, Wang X, Kuang ZD, Shang XY, Lin F, Chang D, Mu JS. Dynamic nomogram predicts sepsis risk in patients with acute liver failure: Analysis of intensive care database with external validation. World J Gastroenterol 2025; 31(31): 105229 [PMID: 40901690 DOI: 10.3748/wjg.v31.i31.105229]
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05232146
Submitted on:
August 19, 2025, 02:35
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Reader Comments:
This study addresses a critical clinical challenge—early identification of sepsis in high-risk ALF patients—using a well-constructed dynamic nomogram (SIALF). The model’s strong performance (AUROC 0.835–0.849) outperforms SOFA and SIRS across both internal/external validation cohorts, highlighting its robustness. Key strengths include:
1. Practical Predictors: Integration of readily available clinical variables (age, total bilirubin, LDH, albumin, mechanical ventilation) enhances feasibility for ICU use.
2. Clinical Utility: The online dynamic nomogram facilitates real-time risk assessment, enabling timely interventions like antibiotic stewardship or organ support.
3. Rigorous Validation: External validation in a Chinese cohort (FMCPH) supports generalizability, despite the derivation cohort’s Western origin.
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