Acute circulatory failure–chronic liver failure–sequential organ failure assessment score: a novel scoring model for mortality risk prediction in critically ill cirrhotic patients with acute circulatory failure

Zhou, Xiaodong; Chen, Qin-Fen; Wang, Zhengxian; Liu, Wen-Yue; Poucke, Sven Van; Mao, Zhi; Wu, Shengjie; Huang, Weijian; Zheng, Ming‐Hua

doi:10.1097/meg.0000000000000817

Cited by 3 publications

(1 citation statement)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, authors discovered that CLIF-SOFA presented an improvement of discriminative ability when incorporate temperature into original CLIF-SOFA. [ 32 ] It indicated that inflammatory factor had great impact weight on mortality and could complement the prognostic accuracy of CLIF-SOFA or CLIF-C OF.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the predictive value of scoring systems on the prognosis of cirrhotic patients with suspected infection

Lan

Wang²,

Shi³

et al. 2018

Medicine

View full text Add to dashboard Cite

Cirrhotic patients with infection are prone to develop sepsis or even septic shock rendering poorer prognosis. However, few methods are available to predict the prognosis of cirrhotic patients with infection although there are some scoring systems can be used to predict general patients with cirrhosis. Therefore, we aimed to explore the predictive value of scoring systems in determining the outcome of critically ill cirrhotic patients with suspected infection.This was a retrospective cohort study based on a single-center database. The prognostic accuracy of the systemic inflammatory response syndrome (SIRS) criteria, quick Sequential Organ Failure Assessment (qSOFA), chronic liver failure (CLIF)-SOFA, quick CLIF-SOFA (qCLIF-SOFA), CLIF-consortium organ failure (CLIF-C OF), Model for End-Stage Liver Disease (MELD), and Simplified Acute Physiology Score (SAPS) II were compared by using area under the receiver operating characteristic (AUROC) curve and net benefit with decision curve analysis. The primary endpoint was in-hospital mortality while the secondary endpoints were duration of hospital and intensive care unit (ICU) stay and ICU mortality.A total of 1438 cirrhotic patients with suspected infection were included in the study. Nearly half the patients (50.2%) were admitted to the ICU due to hepatic encephalopathy and the overall in-hospital mortality was 32.0%. Hospital and ICU mortality increased as the score of each scoring system increased (P < .05 for all trends). The AUROC of CLIF-SOFA (AUROC, 0.742; 95% confidence interval, CI, 0.714–0.770), CLIF-C OF (AUROC, 0.741; 95% CI, 0.713–0.769), and SAPS II (AUROC, 0.759; 95% CI, 0.733–0.786) were significantly higher than SIRS criteria (AUROC, 0.618; 95% CI, 0.590–0.647), qSOFA (AUROC, 0.612; 95% CI, 0.584–0.640), MELD (AUROC, 0.632; 95% CI, 0.601–0.662), or qCLIF-SOFA (AUROC, 0.680; 95% CI, 0.650–0.710) (P < .05 for all). In the decision curve analysis, the net benefit of implementing CLIF-SOFA and CLIF-C OF to predict the prognosis of cirrhotic patients with suspected infection were higher compared with SIRS, qSOFA, MELD, or qCLIF-SOFA.CLIF-SOFA and CLIF-C OF scores, as well as SAPS II were better tools than SIRS, qSOFA, MELD, or qCLIF-SOFA to evaluate the prognosis of critically ill cirrhotic patients with suspected infection.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of the predictive value of scoring systems on the prognosis of cirrhotic patients with suspected infection

Lan

Wang²,

Shi³

et al. 2018

Medicine

View full text Add to dashboard Cite

show abstract

Liver disease and heart failure: Back and forth

Correale

Tarantino

Petrucci

et al. 2018

European Journal of Internal Medicine

View full text Add to dashboard Cite

Comparison of prognostic systems in cirrhotic patients with hepatic encephalopathy

Taş¹,

Yalçın²,

Sarıtaş³

et al. 2018

Turk J Med Sci

View full text Add to dashboard Cite

Background/aim: There are various scoring systems for evaluating prognosis in patients hospitalized in intensive care units (ICUs) with hepatic encephalopathy. These include the Child-Turcotte-Pugh (CTP) classification, Model for End-stage Liver Disease (MELD), chronic liver failure-sequential organ failure assessment (CLIF-SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II). In this study, we aimed to compare the various scoring systems to determine the best system for showing the prognosis of patients with a prior diagnosis of cirrhosis who were hospitalized for hepatic encephalopathy. Materials and methods: Patients with known cirrhosis hospitalized in the internal medicine ICU of the Adana Numune Education and Research Hospital with a diagnosis of hepatic encephalopathy were included in the study. Diagnosis and classification of hepatic encephalopathy were done according to the West Haven criteria. The etiology of hepatic encephalopathy was recorded for all patients. APACHE II, CLIF-SOFA, MELD, and CTP scores were calculated for all patients within the first 24 h. Outcomes of patients were recorded as either discharged or deceased. Demographic and biochemical data, duration of hospitalization, and prognostic factors were compared for both groups. Area under the receiver operating characteristic curve (AUROC) values were calculated for each scoring system. Results: A total of 84 patients were included in the study. The etiologies of encephalopathy were infection (n = 35, 41.7%), variceal bleeding (n = 19, 22.6%), constipation (n = 15, 17.9%), consuming excessive protein (n = 8, 9.5%), hypokalemia (n = 6, 7.1%), and hepatocellular carcinoma (n = 1, 1.2%). Nine patients had grade 1 encephalopathy, 34 patients had grade 2, 27 patients had grade 3, and 14 patients had grade 4. AUROC values were 0.986 (0.970-1.003), 0.974 (0.945-1.003), 0.955 (0.915-0.996), and 0.880 (0.800-0.959) for CLIF-SOFA, APACHE II, CTP, and MELD scores, respectively. Conclusion: We found the best prognostic model for patients who were hospitalized in the ICU for hepatic encephalopathy to be CLIFSOFA, followed by APACHE II, CTP, and MELD scores.

show abstract

Acute circulatory failure–chronic liver failure–sequential organ failure assessment score: a novel scoring model for mortality risk prediction in critically ill cirrhotic patients with acute circulatory failure

Abstract: ACF-CLIF-SOFA, as the first model specific to CICCF, enables a more accurate prediction at 30-day, 90-day, and 1-year follow-up periods than other existing scoring systems.

Cited by 3 publications

References 37 publications

Comparison of the predictive value of scoring systems on the prognosis of cirrhotic patients with suspected infection

Comparison of the predictive value of scoring systems on the prognosis of cirrhotic patients with suspected infection

Liver disease and heart failure: Back and forth

Comparison of prognostic systems in cirrhotic patients with hepatic encephalopathy

Contact Info

Product

Resources

About