CoChat
Sign Up
Cited by 20

The DOI matches its Crossref record.

Development of a Drum Tower Severity Scoring (DTSS) system for pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome

Wang, Xuan, Zhang, Wei, Zhang, Ming, Zhang, Feng, Xiao, Jiangqiang, Yin, Qin, Han, Hao, Li, Taishun, Lin, Ge, Zhuge, Yuzheng·2022·Hepatology International
DOI 10.1007/s12072-021-10293-5PMC PMC9174127
Open this paper in CoChat — free account

Abstract

Background and aims: There has been no reliable severity system based on the prognosis to guide therapeutic strategies for patients with pyrrolizidine alkaloid (PA)-induced hepatic sinusoidal obstruction syndrome (HSOS). We aimed to create a novel Drum Tower Severity Scoring (DTSS) system for these patients to guide therapy. Methods: 172 Patients with PA-HSOS who received supportive care and anticoagulation therapy in Nanjing Drum Tower Hospital from January 2008 to December 2020 were enrolled and analyzed retrospectively. These patients were randomized into a training or validation set in a 3:1 ratio. Next, we established and validated the newly developed DTSS system. Results: Analysis identified a predictive formula: logit (P) = 0.004 × aspartate aminotransferase (AST, U/L) + 0.019 × total bilirubin (TB, μmol/L) − 0.571 × fibrinogen (FIB, g/L) − 0.093 × peak portal vein velocity (PVV, cm/s) + 1.122. Next, we quantified the above variables to establish the DTSS system. For the training set, the area under the ROC curve (AUC) (n = 127) was 0.787 [95% confidence interval (CI) 0.706–0.868; p < 0.001]. With a lower cut-off value of 6.5, the sensitivity and negative predictive value for predicting no response to supportive care and anticoagulation therapy were 94.7% and 88.0%, respectively. When applying a high cut-off value of 10.5, the specificity was 92.9% and the positive predictive value was 78.3%. For the validation set, the system performed stable with an AUC of 0.808. Conclusions: The DTSS system can predict the outcome of supportive care and anticoagulation in PA-HSOS patients with satisfactory accuracy by evaluating severity, and may have potential significance for guiding therapy.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s12072-021-10293-5

Cites

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 23

  1. Zhu L, Zhang CY, Li DP, et al. Tu-San-Qi (Gynura japonica): the culprit behind pyrrolizidine alkaloid-induced liver injury in China. Acta Pharmacol Sin 2021;42(8):1212–1222. https://doi.org/10.1038/s41401-020-00553-9 · DOI
  2. Yang XQ, Ye J, Li X, et al. Pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome: pathogenesis, clinical manifestations, diagnosis, treatment, and outcomes. World J Gastroenterol 2019;25(28):3753–3763. https://doi.org/10.3748/wjg.v25.i28.3753 · DOI · Paper page
  3. Liu F, Rong X, Guo H, et al. Clinical characteristics, CT signs, and pathological findings of Pyrrolizidine alkaloids-induced sinusoidal obstructive syndrome: a retrospective study. BMC Gastroenterol 2020;20(1):30. https://doi.org/10.1186/s12876-020-1180-0(Published 2020 Feb 4) · DOI
  4. Zhuge YZ, Wang Y, Zhang F, et al. Clinical characteristics and treatment of pyrrolizidine alkaloid-related hepatic vein occlusive disease. Liver Int 2018;38(10):1867–1874. https://doi.org/10.1111/liv.13684 · DOI
  5. Zhuge Y, Liu Y, Xie W, et al. Expert consensus on the clinical management of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome. J Gastroenterol Hepatol 2019;34(4):634–642. https://doi.org/10.1111/jgh.14612 · DOI · Paper page
  6. Wang Y, Qiao D, Li Y, Xu F. Risk factors for hepatic veno-occlusive disease caused by Gynura segetum: a retrospective study. BMC Gastroenterol 2018;18(1):156. https://doi.org/10.1186/s12876-018-0879-7(Published 2018 Oct 26) · DOI
  7. Dong XF, Wang QC, Zhu XH, et al. Application and clinical analysis of anticoagulant and thrombolytic therapy in hepatic venular occlusive disease caused by Tu sanqi. Chin Hepatol 2018;23(11):985–987 (in Chinese)
  8. Mohty M, Malard F, Abecassis M, et al. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a new classification from the European Society for blood and marrow transplantation. Bone Marrow Transplant 2016;51(7):906–912. https://doi.org/10.1038/bmt.2016.130 · DOI
  9. Peng C, Zhang X, Zhang F, et al. Clinical efficacy and safety of anticoagulation therapy for Pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome: a retrospective multicenter cohort study. Eur J Gastroenterol Hepatol 2020;32(9):1168–1178. https://doi.org/10.1097/MEG.0000000000001630 · DOI
  10. Smith A, Baumgartner K, Bositis C. Cirrhosis: diagnosis and management. Am Fam Physician 2019;100(12):759–770
  11. American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Practice guidelines for perioperative blood transfusion and adjuvant therapies: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Anesthesiology 2006;105(1):198–208. https://doi.org/10.1097/00000542-200607000-00030 · DOI
  12. Kozek-Langenecker SA, Ahmed AB, Afshari A, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: first update 2016. Eur J Anaesthesiol 2017;34(6):332–395. https://doi.org/10.1097/EJA.0000000000000630 · DOI
  13. Xiao J, Tu J, Zhang H, et al. Risk factors of poor prognosis in patients with pyrrolidine alkaloid-induced hepatic sinusoidal obstruction syndrome after transjugular intrahepatic portosystemic shunt. Hepatol Int 2021. https://doi.org/10.1007/s12072-020-10126-x(published online ahead of print, 2021 Jan 28) · DOI
  14. Chinese Society of Hepatology, Chinese Medical Association, Xu X, Duan Z, et al. Chinese guidelines on the management of ascites and its related complications in cirrhosis. Hepatol Int 2019;13(1):1–21. https://doi.org/10.1007/s12072-018-09923-2 · DOI
  15. Zhang W, Liu L, Zhang M, et al. Validation of the Nanjing criteria for diagnosing pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome. J Clin Transl Hepatol 2021;9(3):345–352. https://doi.org/10.14218/JCTH.2020.00124 · DOI · Paper page
  16. Nassereddine S, Alsubait S, Tabbara I. Sinusoidal obstruction syndrome (veno-occlusive disease) following hematopoietic stem cell transplant: insights and therapeutic advances. Anticancer Res 2018;38(5):2597–2605. https://doi.org/10.21873/anticanres.12501 · DOI
  17. Mohty M, Malard F, Abecassis M, et al. Sinusoidal obstruction syndrome/veno-occlusive disease: current situation and perspectives-a position statement from the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2015;50:781–789 · DOI
  18. Wang X, Qi X, Guo X. Tusanqi-related sinusoidal obstruction syndrome in china: a systematic review of the literatures. Medicine (Baltimore) 2015;94(23): e942. https://doi.org/10.1097/MD.0000000000000942 · DOI
  19. Chao N. How I treat sinusoidal obstruction syndrome. Blood 2014;123(26):4023–4026. https://doi.org/10.1182/blood-2014-03-551630 · DOI
  20. Hou CL, Xu J, Qin HL, et al. Efficacy of transjugular intrahepatic portosystemic shunt in the treatment of 21 patients with Gynura segetum-related hepatic sinusoidal obstruction syndrome. Chin J Dig 2019;39:251–256 (in Chinese)
  21. Chen YR, Zhang W, Zhang M, et al. Prognostic value of the PA-HSOS criteria for severity grading in PA-HSOS patients treated with TIPS. Chin J Heptol 2021;29(01):46–53 ((in Chinese))
  22. Gao H, Ruan JQ, Chen J, et al. Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome. Drug Des Dev Ther 2015;9:4861–4868. https://doi.org/10.2147/DDDT.S87858 (Published 2015 Aug 25) · DOI · Paper page
  23. Ma J, Zhang W, He Y, et al. Clinical application of pyrrole-hemoglobin adducts as a biomarker of pyrrolizidine alkaloid exposure in humans. Arch Toxicol 2021;95(2):759–765. https://doi.org/10.1007/s00204-020-02947-4 · DOI

Cited by

Sorted by citations

See all 20

Metadata

Authors
Wang, X., Zhang, W., Zhang, M., Zhang, F., Xiao, J., Yin, Q., Han, H., Li, T., Lin, G., & Zhuge, Y.
Venue
Hepatology International
Publisher
Springer Science and Business Media LLC
Published
2022-01-12
Volume
16
Issue
3
Pages
669-679
ISSN
  • 1936-0533
  • 1936-0541
DOI
10.1007/s12072-021-10293-5
PMC
PMC9174127
Cited by
20
References
0
Language
en
Licence
Funders
Nanjing Medical Science and Technique Development Foundation (NO. ZKX19015)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review