Prognostic Factors of Patients with Decompensated Hepatitis B Cirrhosis and Establishment of a Risk Prediction Model

Background: We aimed to explore the prognostic factors in patients with decompensated hepatitis B cirrhosis (HBC) and to establish a risk prediction model. Methods: In this prospective study, 120 subjects were selected from patients with decompensated HBC who were hospitalized between January 2022 and January 2023. All patients were followed for one year. Using death during follow-up as the prognostic endpoint, patients were categorized into a good prognosis (survival) group and a poor prognosis (death) group. Demographic data and laboratory indicators were compared between the two groups. Risk factors were identified using multivariate logistic regression analysis, and a risk prediction model was subsequently established. Results: There were 30 cases (25%) in the poor prognosis group and 90 cases (75%) in the good prognosis group. The incidence of hypoproteinemia, international normalized ratio (INR), and the levels of total cholesterol (TC), cell-free deoxyribonucleic acid (cfDNA), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were significantly higher in the poor prognosis group compared to the good prognosis group (P < 0.05). Hypoproteinemia, cfDNA, GM-CSF, and INR were identified as risk factors for poor prognosis in patients with decompensated HBC [odds ratio (OR) > 1, P < 0.05], while TC was identified as a protective factor (OR < 1, P < 0.05). A regression equation was established as follows: Logit (P) = -12.544 + 1.376 × cfDNA + 1.051 × GM-CSF + 1.025 × INR + 0.675 × TC + 4.136 × hypoproteinemia. The area under the curve (AUC) for this model was 0.920 [95% confidence interval: 0.855 - 0.980, P < 0.001], indicating high reliability and stability. Conclusions: Hypoproteinemia, INR, cfDNA, and GM-CSF are risk factors for poor prognosis in patients with decompensated HBC.