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. 2024 Feb 19;13(4):1181.
doi: 10.3390/jcm13041181.

Development and Internal Validation of a Model for Predicting Overall Survival in Subjects with MAFLD: A Cohort Study

Caterina Bonfiglio  1 , Angelo Campanella  1 , Rossella Donghia  1 , Antonella Bianco  1 , Isabella Franco  1 , Ritanna Curci  1 , Claudia Beatrice Bagnato  1 , Rossella Tatoli  1 , Gianluigi Giannelli  1 , Francesco Cuccaro  2
Affiliations

Development and Internal Validation of a Model for Predicting Overall Survival in Subjects with MAFLD: A Cohort Study

Caterina Bonfiglio et al. J Clin Med. .

Abstract

Background & Aims: Fatty liver disease with metabolic dysfunction (MAFLD) is a new concept proposed to replace the previous concept of Non-Alcoholic Hepatic Steatosis (NAFLD). We developed and internally validated a prognostic model to predict the likelihood of death in a cohort of subjects with MAFLD. Methods: Our work involved two steps: the first was the construction of a bootstrapped multivariable Cox model for mortality risk prognosis and the second was its validation. Results: The study cohort included 1506 subjects, of which 907 were used for internal validation. Discriminant measures for the final model were R2D 0.6845 and Harrell's C 0.8422 in the development and R2D 0.6930 and Harrell's C 0.8465 in the validation. We used the nine independent prognostic factors selected by the LASSO Cox procedure and fitted by the bootstrap Cox survival model, and observed β were: Gender 0.356 1.42 (p < 0.008), Age 0.146 (p < 0.001), Glycemia 0.004 (p < 0.002), Total Cholesterol -0.0040 (p < 0.009), Gamma Glutamyl Transpeptidase 0.009 (p < 0.001), SBP 0.009 (p < 0.036), DBP -0.016 (p < 0.041), ALP 0.008 (p < 0.071) and Widowhood 0.550 (p < 0.001). Conclusions: We produced and validated a model to estimate the probability of death in subjects with MAFLD. The instruments we used showed satisfactory predictive capabilities.

Keywords: MAFLD; mortality; prognostic index.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Participant flow.
Figure 2
Figure 2
Kaplan–Meier curves and predicted mean survival curves in the development cohort.
Figure 3
Figure 3
Calibration plot for the survival prediction model in the validation cohort. The red line shows the pseudo-values at the time of 17 years. The green line shows the perfect calibration. In gray the 95% CI.
Figure 4
Figure 4
Kaplan–Meier curves for the development cohort by prognostic index groups.
See this image and copyright information in PMC

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