An RFH-NPT-based nomogram for predicting the long-term survival of liver cirrhosis patients: a multicenter study.

Background And Aims: The Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) identifies nutritional risk in patients with liver disease, an important factor in cirrhosis outcomes. Recognizing the gap in existing prognostic models, which often overlook malnutrition, we developed and validated an RFH-NPT-based model for predicting outcomes of patients with cirrhosis.

Methods: This study included inpatients with cirrhosis from a single center between February and July 2016 (training cohort) and patients from six other medical centers admitted between December 2011 and May 2022 (validation cohort). RFH-NPT assessment was conducted at admission, followed by a 5-year follow-up. A nomogram was created using prognostic variables from Cox modeling, best subset regression (BSR), and least absolute shrinkage and selection operator (LASSO) regression. Its performance was evaluated using various statistical methods and compared with that of existing models such as the Child‒Pugh, MELD, and MELD-Na.

Results: A total of 152 patients were included in the training cohort. The nutritional risk was significantly greater in nonsurvivors (81.1%) than in survivors (46.5%). The nomogram showed better accuracy in predicting 1-, 3-, and 5-year survival than traditional methods. The nomogram's effectiveness was confirmed in the validation cohort of 320 patients.

Conclusion: This study re-emphasizes the critical role of malnutrition in patients with liver cirrhosis and establishes an effective RFH-NPT-based model for outcome prediction.

Clinical Trial Registration: This study is registered at Clinicaltrials.gov (NCT05513651).