A novel integrated <scp>M</scp>odel for <scp>E</scp>nd‐<scp>S</scp>tage <scp>L</scp>iver <scp>D</scp>isease model predicts short‐term prognosis of hepatitis <scp>B</scp> virus‐related acute‐on‐chronic liver failure patients

Yan, Huadong; Wu, Wei; Yang, Ying; Wu, Yihua; Yang, Qiao; Shi, Yu

doi:10.1111/hepr.12362

Cited by 27 publications

(28 citation statements)

References 24 publications

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“…In a previous study, we have demonstrated chronic liver failure-sequential organ failure assessment (CLIF-SOFA) criteria to be better than APASL criteria in defining ACLF. 8 Various scoring systems like ChildTurcotte-Pugh (CTP), 9 model for end-stage liver disease (MELD), 10 integrated MELD (iMELD) score, 11 acute physiology and chronic health evaluation (APACHE II), 12 and CLIF-SOFA score 8 have been used for prediction of mortality in ACLF. Studies across the globe have shown increased mortality and worse prognosis in patients of cirrhosis presenting as ACLF.…”

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confidence: 99%

Impact of Hepatic and Extrahepatic Insults on the Outcome of Acute-on-Chronic Liver Failure

Gupta

Dhiman

Rathi

et al. 2017

Journal of Clinical and Experimental Hepatology

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Background: To study the differences in outcome and predictors of mortality in acute-on-chronic liver failure (ACLF) precipitated by hepatic or extrahepatic insults. Methods: Consecutive patients of cirrhosis with acute decompensation were prospectively included and followed up for 90 days from admission. ACLF was defined based on chronic liver failure (CLIF) acute-on-chronic liver failure in cirrhosis (CANONIC study) criteria. Acute worsening due to acute viral hepatitis A and E, hepatitis B flare, alcoholic hepatitis, autoimmune hepatitis flare, or drug-induced liver injury were categorized as hepatic ACLF and that due to bacterial infection, upper gastrointestinal bleed or surgery as extrahepatic ACLF. Patients with both hepatic and extrahepatic insults were included in combined insult group. Results: Of 179 patients of acute decompensation, 122 had ACLF (hepatic insults 47 and extrahepatic insults 51). Alcohol (64.8%) was the most common etiology of cirrhosis while infection (36%) was the most common acute insult followed by alcoholic hepatitis (24.6%). Higher proportion of extrahepatic ACLF patients had history of prior decompensation than hepatic ACLF patients (62.7% vs. 27.7%, P < 0.001). There was no difference in mortality among hepatic and extrahepatic ACLF groups at 28 and 90 days (53.2% vs. 56.9%, P = 0.715 and 85% vs. 74.5%, P = 0.193, respectively). Area under receiver-operating curve (AUROC) for 28-day mortality in extrahepatic ACLF group was 0.788, 0.724, 0.718, 0.634, and 0.726 and in hepatic-ACLF group was 0.786, 0.625, 0.802, 0.761, and 0.648 for chronic liver failure-sequential organ failure assessment (CLIF-SOFA), model for end stage liver disease (MELD), integrated MELD score (iMELD), acute physiology and chronic health evaluation score (APACHE-II), and Child-Turcotte-Pugh score scores, respectively. Conclusion: There is no difference in mortality among hepatic and extrahepatic ACLF groups at 28 and 90 days. iMELD and CLIF-SOFA have highest AUROC to predict 28-day mortality in hepatic and extrahepatic ACLF groups, respectively. ( J CLIN EXP HEPATOL 2017;7:9-15)

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confidence: 99%

Impact of Hepatic and Extrahepatic Insults on the Outcome of Acute-on-Chronic Liver Failure

Gupta

Dhiman

Rathi

et al. 2017

Journal of Clinical and Experimental Hepatology

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“…) . MELD score was the most commonly used scoring system, which was used in 24 studies (28 cohorts) involving 4663 patients . Followed by CPT score, which was used in 12 studies (16 cohorts) involving 2226 patients .…”

Section: Resultsmentioning

confidence: 99%

Performance of scoring systems to predict mortality of patients with acute‐on‐chronic liver failure: A systematic review and meta‐analysis

Zheng

Zhong

et al. 2017

J of Gastro and Hepatol

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“…This finding was consistent with some other studies. [24,25] AFP is generally regarded as a biomarker of hepatocellular carcinoma and embryonal cell cancer, while it also rises transiently in benign acute or chronic liver injury. Some studies have found the highest concentration of cellular AFP in hepatocytes in front of the necroses.…”

Section: Discussionmentioning

confidence: 99%

A new multiparameter integrated MELD model for prognosis of HBV-related acute-on-chronic liver failure

Luo

et al. 2016

Medicine

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A novel integrated Model for End‐Stage Liver Disease model predicts short‐term prognosis of hepatitis B virus‐related acute‐on‐chronic liver failure patients

Abstract: HBV-ACLF patients are characterized by high short-term mortality, but steady long-term survival. A modified MELD model by incorporating age and HE score has better predictive value of 3-month mortality than other conventional models.

Cited by 27 publications

References 24 publications

Impact of Hepatic and Extrahepatic Insults on the Outcome of Acute-on-Chronic Liver Failure

Impact of Hepatic and Extrahepatic Insults on the Outcome of Acute-on-Chronic Liver Failure

Performance of scoring systems to predict mortality of patients with acute‐on‐chronic liver failure: A systematic review and meta‐analysis

A new multiparameter integrated MELD model for prognosis of HBV-related acute-on-chronic liver failure

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