Validation of prognostic scores to predict short‐term mortality in patients with acute‐on‐chronic liver failure

Song, Do Seon; Kim, Tae Yeob; Kim, Dong Joon; Kim, Hee Yeon; Sinn, Dong Hyun; Yoon, Eileen L.; Kim, Chang Wook; Jung, Young Kul; Suk, Ki Tae; Lee, Sang Soo; Lee, Chang Hyeong; Kim, Tae Hun; Choe, Won Hyeok; Yim, Hyung Joon; Kim, Sung Eun; Baik, Soon Koo; Jang, Jae Young; Kim, Hyoung Su; Kim, Sang Gyune; Yang, Jin Mo; Sohn, Joo Hyun; Choi, Eun Hee; Cho, Hyun Chin; Jeong, Soung Won; Kim, Moon Young

doi:10.1111/jgh.13991

Cited by 26 publications

(18 citation statements)

References 22 publications

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“…The disease severity assessment is needed for prognostication and to guide the therapy [144][145][146]. Disease severity scores such as model for end-stage liver disease (MELD) have been considered for organ allocation.…”

Section: Prognostic Models and Disease Severity Scoresmentioning

confidence: 99%

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

et al. 2019

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The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the “APASL ACLF Research Consortium (AARC)” was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the ‘Golden Therapeutic Window’, extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information and areas requiring future studies are presented here.

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Section: Prognostic Models and Disease Severity Scoresmentioning

confidence: 99%

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

et al. 2019

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“…Recently, the CLIF-ACLF score, CLIF-C OF score, and CLIF-SOFA score have been used to evaluate prognosis in ACLF patients (Engelmann et al, 2018;Song et al, 2018). To the best of our knowledge, although the discriminative ability of these scores for predicting outcomes in ACLF patients has been illustrated, different conclusions have been drawn regarding the relative predictive value of these scores because of differences in study populations or observation durations.…”

Section: Discussionmentioning

confidence: 99%

Assessing the prognostic scores for the prediction of the mortality of patients with acute-on-chronic liver failure: a retrospective study

Zhang

Nie

Liu

et al. 2020

PeerJ

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Background Acute-on-chronic liver failure (ACLF), which is characterized by rapid deterioration of liver function and multiorgan failure, has high mortality. This study was designed to identify prognostic scores to predict short-term and long-term outcome in patients with ACLF to facilitate early treatment and thereby improve patient survival. Materials and Methods We retrospectively analyzed 102 ACLF patients who were hospitalized in the gastroenterology department. The EASL-CLIF criteria were used to define the ACLF. The demographic characteristics and biochemical examination results of the patients were acquired, and seven scores (CTP score, MELD score, MELD-Na, CLIF ACLF score, CLIF-C OF score, and CLIF SOFA score) were calculated 24 h after admission. All patients were observed until loss to follow-up, death, or specific follow-up times (28 days, 3 months, and 6 months), which were calculated after the initial hospital admission. The receiver operating characteristic (ROC) curve was employed to estimate the power of six scores to forecast ACLF patients’ outcome. Results All scores were distinctly higher in nonsurviving patients than in surviving patients and had predictive value for outcome in patients with ACLF at all time points (P < 0.050). The areas under the ROC curve (AUROCs) of the CLIF-SOFA score were higher than those of other scores at all time points. The comparison of the AUROC of the CLIF-SOFA score with other scores was statistically significant at 28 days (P < 0.050), which was the only time point at which it was greater than 0.800. Conclusion Patients with ACLF have high mortality. These six scores are effective tools for assessing the prognosis of ACLF patients. The CLIF-SOFA score is especially effective for evaluating 28-day mortality.

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“…2 The CLIF-SOFA score has been validated as useful in predicting outcomes in ACLF patients. 4 The model of end-stage liver disease (MELD) score was first applied to predict survival in patients undergoing transjugular intrahepatic portosystemic shunts (TIPS). 5 In addition, the MELD score has been broadly employed to predict the risk of mortality in patients with cirrhosis and serves as a predictor of survival in patients awaiting liver transplantation (LT).…”

Section: Introductionmentioning

confidence: 99%

Assessing the Prediction Effect of Various Prognosis Model for 28-Day Mortality in Acute-on-Chronic Liver Failure Patients

Liu¹,

Zhang²,

Nie³

et al. 2020

RMHP

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Validation of prognostic scores to predict short‐term mortality in patients with acute‐on‐chronic liver failure

Abstract: The CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs are useful scoring systems that provide accurate information on prognosis in patients with ACLF according to the CLIF-C definition, but not the AARC definition.

Cited by 26 publications

References 22 publications

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

Assessing the prognostic scores for the prediction of the mortality of patients with acute-on-chronic liver failure: a retrospective study

Assessing the Prediction Effect of Various Prognosis Model for 28-Day Mortality in Acute-on-Chronic Liver Failure Patients

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