Development of a deep learning model for guiding treatment decisions of acute variceal bleeding in patients with cirrhosis

Table 1 Baseline characteristics and outcomes of acute variceal bleeding patients in the training, internal validation and external validation cohort, mean ± SD/n (%)

Characteristics	Training cohort (n = 668)	Internal validation cohort (n = 167)	P value	External validation cohort (n = 392)
Demographic characteristics
Age (years)	52.5 ± 11.8	52.6 ± 10.2	0.927	53.1 ± 11.8
Sex			0.273
Male	473 (70.8)	126 (75.4)		278 (70.9)
Female	195 (29.2)	41 (24.6)		114 (29.1)
Etiology of cirrhosis			0.394
Chronic HBV infection	401 (60.0)	117 (70.1)		246 (62.8)
Chronic HCV infection	41 (6.1)	10 (6.0)		28 (7.1)
Alcohol	73 (10.9)	16 (9.6)		56 (14.3)
Others	92 (13.8)	14 (8.3)		35 (8.9)
Cryptogenic	61 (9.1)	10 (6.0)		27 (6.9)
Medical history
Previous variceal bleeding	240 (35.9)	65 (38.9)	0.407	163 (41.6)
Location of varices			0.299
Esophageal varices only	388 (58.0)	105 (62.9)		214 (54.6)
Esophageal and gastric varices	280 (42.0)	62 (37.1)		178 (45.4)
Hepatic encephalopathy	65 (9.7)	17 (10.2)	0.437	33 (8.4)
Ascites			0.502
Mild	237 (35.4)	76 (45.5)		142 (36.2)
Moderate	96 (14.4)	31 (18.6)		68 (17.4)
Massive	45 (6.7)	13 (7.8)		30 (7.7)
Heart rate at admission (beats/minute)	85.0 ± 15.6	85.7 ± 16.6	0.632	87.5 ± 15.5
Systolic blood pressure at admission (mmHg)	115.8 ± 17.5	116.5 ± 16.2	0.640	113.6 ± 19.8
Diastolic blood pressure at admission (mmHg), median IQR	71.0 (63-79)	71.0 (62.5-79.5)	0.746	64.0 (55.5-72.5)
Laboratory examination
White blood cell (× 109 cell/L), median IQR	7.3 (5.4-10.0)	7.6 (6.2-9.0)	0.052	7.6 (5.3-9.7)
Red blood cell (× 109 cell/L)	2.7 ± 0.8	2.8 ± 0.7	0.483	2.3 ± 0.6
Hemoglobin (g/L)	77.3 ± 22.3	78.5 ± 23.4	0.521	70.8 ± 24.8
Platelet count (× 109/L), median IQR	84.0 (61.0-117.0)	85.0 (62.5-128.0)	0.867	94.5 (69.0-129.0)
NEC (× 109/L), median IQR	5.7 (4.3-8.0)	5.7 (4.3-8.2)	0.674	6.3 (3.8-12.5)
AST (U/L), median IQR	94.0 (83.7-118.2)	104.0 (93.0-125.5)	0.561	113.0 (103.5-133.0)
ALT (U/L), median IQR	54.0 (46.0-67.0)	53.0 (46.0-62.5)	0.681	56.0 (49.0-70.0)
TBIL (μmol/L)	38.0 ± 63.2	34.4 ± 38.0	0.577	33.0 ± 33.2
Albumin (g/L)	28.5 ± 5.4	29.0 ± 5.0	0.267	31.7 ± 8.8
INR	1.4 ± 2.7	1.3 ± 0.3	0.606	1.6 ± 1.5
APTT (second)	38.4 ± 16.3	36.6 ± 9.8	0.176	37.2 ± 13.4
TT (second)	19.9 ± 3.6	19.4 ± 3.2	0.124	19.8 ± 5.8
PT (second), median IQR	14.2 (12.9-15.8)	13.9 (12.9-15.6)	0.269	15.4 (13.9-17.9)
Creatinine (μmol/L), median IQR	92.0 (81.0-107.0)	90.0 (80.0-102.5)	0.814	86.0 (75.0-105.0)
Risk stratification index
MELD score (points)	11.3 ± 3.2	12.1 ± 5.0	0.049	12.2 ± 3.7
Child-Pugh score (points), median IQR	8.0 (7.0-9.0)	8.0 (7.0-9.1)	0.797	7.0 (5.5-8.5)
Child-Pugh class			0.395
A (5-6)	142 (21.3)	29 (17.4)		125 (31.9)
B (7-9)	407 (60.9)	111 (66.5)		180 (45.9)
C (10-13)	119 (17.8)	27 (16.2)		87 (22.2)
Early TIPS criteria			0.745
Low risk	534 (79.9)	136 (81.4)		280 (71.4)
High risk	134 (20.1)	31 (18.6)		112 (28.6)
Treatment procedure
Initial pharmacological therapy			0.275
Octreotide	177 (26.5)	47 (28.1)		90 (22.9)
Somatostatin	403 (60.3)	91 (54.5)		255 (65.1)
Terlipressin	88 (13.2)	29 (17.4)		47 (12.0)
Outcome measurements
6-week treatment failure to control bleeding	78 (11.8)	22 (13.2)	0.113	55 (14.0)
ICU requirement	155 (23.2)	38 (22.8)	0.785	81 (20.7)
1-year mortality	126 (18.8)	30 (18.0)	0.261	67 (17.1)
Treatment-related adverse events
Hepatic encephalopathy	86 (12.9)	26 (15.6)	0.093	74 (18.9)
New or worsening ascites	18 (2.7)	3 (1.8)	0.194	10 (2.6)

HBV: Hepatitis B virus; HCV: Hepatitis C virus; IQR: Interquartile range; NEC: Neutrophil count; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; TBIL: Total bilirubin; INR: International normalized ratio; APTT: Activated partial thromboplastin time; TT: Thrombin time; PT: Prothrombin time; MELD: Model for end-stage liver disease; TIPS: Transjugular intrahepatic portosystemic shunt; ICU: Intensive care unit.