EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease

Abstract

Acute-on-chronic liver failure (ACLF) is associated with high mortality. Objective prognostic scores are important for treatment decisions. EASIX (Endothelial Activation and Stress Index) is a simple biomarker consisting of LDH, platelets, and creatinine, reflecting endothelial dysfunction after allogeneic stem cell transplantation. Considering endothelial dysfunction in the pathogenesis of ACLF, this study aimed to test the discriminative ability of EASIX in advanced liver disease. We retrospectively analysed the prognostic potential of EASIX to predict 28-day and 3-month mortality in a total of 188 liver cirrhotic patients requiring treatment at the intensive care unit. We evaluated the ability of EASIX to rule out early infections and predict the need for hemodialysis. EASIX performed moderately better than established scores in predicting 28-day mortality (AUC = 0.771) and was nearly equivalent (AUC = 0.791) to SOFA and APACHE-II in the prediction of 3-month mortality. Importantly, EASIX showed better diagnostic potential in ruling out clinically apparent infections than common proinflammatory markers (AUC = 0.861, p < 0.001) and showed suitable accuracy in predicting the need for hemodialysis (AUC = 0.833). EASIX is an accurate, objective and easily assessable biomarker for predicting mortality and complications in patients with advanced liver disease.

EASIX is an effective marker in predicting mortality of traumatic brain injury patients

“…An index named EASIX was primarily designed and confirmed as an effective predictor of overall survival among patients with steroid-refractory graft-versus-host disease after allogeneic stem-cell transplantation which was associated with the thrombotic microangiopathy through endothelial dysfunction [7]. Then, the prognostic value of the EASIX incorporating lactate dehydrogenase, serum creatinine and platelet was verified in many kinds of patients including lower risk myelodysplastic syndromes, multiple myeloma, COVID-19, diffuse large B-cell lymphoma, small cell lung cancer, sepsis, and critically ill patients with advanced liver disease [10][11][12][13][14][15]. Some studies showed the significant correlation between the EASIX and levels of endothelial activation markers including interleukin-18, chemokine-X-C-ligand 8, C-X-C motif chemokine ligand 9, insulin like-growth-factor-1, suppressor of tumorigenicity-2, angiopoietin-2, soluble thrombomodulin [8,9].…”