Predicting mortality for cirrhotic patients with acute oesophageal variceal haemorrhage using liver‐specific scores

Terres, Alana Zulian; Balbinot, Rafael Sartori; Muscope, Ana Laura Facco; Eberhardt, Louise Zanotto; Balensiefer, Juline Isabel Leichtweis; Cini, Bruna Teston; Rost, Gilberto Luis; Longen, Morgana Luisa; Schena, Bruna; Balbinot, Raul Angelo; Soldera, Jonathan

doi:10.1002/ygh2.460

Cited by 7 publications

(8 citation statements)

References 64 publications

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“…Also, higher CLIF-SOFA values were associated with lower survival. This has been already demonstrated in previous studies for other causes of decompensation, such as alcoholic hepatitis and alcoholic cirrhosis (58,59) , extra-hepatic insults (36,60) , acute variceal bleeding (61,62) , cirrhotic patients admitted to the intensive care unit (63) , with hepatorenal syndrome (64) or SBP (65) .…”

Section: Discussionsupporting

confidence: 61%

Acute-on-Chronic Liver Failure Is Independently Associated With Lower Survival in Patients With Spontaneous Bacterial Peritonitis

Jacques

Massignan

Winkler

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a decompensation of cirrhosis with an in-hospital mortality ranging from 20% to 40%. OBJECTIVE: The purpose of this study is to analyze if EASL-CLIF definition of acute-on-chronic liver failure (ACLF) is able to predict mortality in cirrhotic patients with SBP. METHODS: Historical cohort study conducted in a public tertiary care teaching hospital. Data from medical records from January 2009 to July 2016 were obtained by searching the hospital electronic database for samples of ascites collected in the period. Electronic and physical medical records were analyzed and patients were included if they were over 18-years old, with cirrhosis and an ascites fluid compatible with SBP: 69 patients were included. Liver-specific scores were calculated and Kaplan-Meier survival analysis was used for univariate analysis and a stepwise approach to the Cox regression for multivariate analysis. RESULTS: All cause mortality was 44%, 56.5% and 74% for 28-, 90- and 365-day, respectively. The prevalence of ACLF was 58%. Of these, 65% grade 1, 17.5% grade 2 and 17.5% grade 3. In multivariate analysis, the use of proton-pump inhibitors, alanine transaminase lower than 40 U/L, hemoglobin higher than 9 g/dL, absence of ACLF and lower CLIF-SOFA and MELD scores were independently associated with higher survival for both 28- and 90-day interval. CONCLUSION: The presence of ACLF and higher CLIF-SOFA scores were independently associated with higher 28- and 90-day mortality in cirrhotic patients admitted due to SBP.

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Section: Discussionsupporting

confidence: 61%

Acute-on-Chronic Liver Failure Is Independently Associated With Lower Survival in Patients With Spontaneous Bacterial Peritonitis

Jacques

Massignan

Winkler

et al. 2021

Arq. Gastroenterol.

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“…Compared with other non-invasive indicators, our NM has stronger identification accuracy and has better clinical value for HBV- induced cirrhosis patients EVH prediction, prevention, and treatments. Further studies apply the chronic liver failure group-sequential organ failure assessment score [46] to predict mortality in cirrhotic patients who develop EVH may provide more relevance of clinical score in predicting outcomes, particularly in cirrhotic patients. The sample size of 241 patients in our study is reasonable for a case-control study.…”

Section: Discussionmentioning

confidence: 99%

Assessment of nomogram model for the prediction of esophageal variceal hemorrhage in hepatitis B-induced hepatic cirrhosis

Xu,

Tan,

Jiang

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Background Esophageal variceal (EV) hemorrhage is a life-threatening consequence of portal hypertension in hepatitis B virus (HBV) -induced cirrhotic patients. Screening upper endoscopy and endoscopic variceal ligation to find EVs for treatment have complications, contraindications, and high costs. We sought to identify the nomogram models (NMs) as alternative predictions for the risk of EV hemorrhage. Methods In this case-control study, we retrospectively analyzed 241 HBV-induced liver cirrhotic patients treated for EVs at the Second People’s Hospital of Fuyang City, China from January 2021 to April 2023. We applied univariate analysis and multivariate logistic regression to assess the accuracy of various NMs in EV hemorrhage. The area under the curve (AUC) and calibration curves of the receiver’s operating characteristics were used to evaluate the predictive accuracy of the nomogram. Decision curve analysis (DCA) was used to determine the clinically relevant of nomograms. Results In the prediction group, multivariate logistic regression analysis identified platelet distribution and spleen length as independent risk factors for EVs. We applied NMs as the independent risk factors to predict EVs risk. The NMs fit well with the calibration curve and have good discrimination ability. The AUC and DCA demonstrated that NMs with a good net benefit. The above results were validated in the validation cohort. Conclusion Our non-invasive NMs based on the platelet distribution width and spleen length may be used to predict EV hemorrhage in HBV-induced cirrhotic patients. NMs can help clinicians to increase diagnostic performance leading to improved treatment measures.

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“…CTP was superior to CLIF-SOFA, CLIF-ACLF, MELD, and MELD-Na in estimating 30-d and 90-d mortality in AD patients, while CLIF-SOFA was better in ACLF patients with acute oesophageal variceal haemorrhage (AOVH) who received terlipressin[ 40 ].…”

Section: Discussionmentioning

confidence: 99%

CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review

Rashed¹,

Soldera²

2022

World J Hepatol

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BACKGROUND Acute-on-chronic liver failure (ACLF) is a syndrome characterized by decompensation in individuals with chronic liver disease, generally secondary to one or more extra-hepatic organ failures, implying an elevated mortality rate. Acute decompensation (AD) is the term used for one or more significant consequences of liver disease in a short time and is the most common reason for hospital admission in cirrhotic patients. The European Association for the Study of Liver-Chronic-Liver Failure (EASL-CLIF) Group modified the intensive care Sequential Organ Failure Assessment score into CLIF-SOFA, which detects the presence of ACLF in patients with or without AD, classifying it into three grades . AIM To investigate the role of the EASL-CLIF definition for ACLF and the ability of CLIF-SOFA, CLIF-C ACLF, and CLIF-C AD scores for prognosticating ACLF or AD. METHODS This study is a literature review using a standardized search method, conducted using the steps following the guidelines for reporting systematic reviews set out by the PRISMA statement. For specific keywords, relevant articles were found by searching PubMed, ScienceDirect, and BioMed Central-BMC. The databases were searched using the search terms by one reviewer, and a list of potentially eligible studies was generated based on the titles and abstracts screened. The data were then extracted and assessed on the basis of the Reference Citation Analysis ( ). RESULTS Most of the included studies used the EASL-CLIF definition for ACLF to identify cirrhotic patients with a significant risk of short-term mortality. The primary outcome in all reviewed studies was mortality. Most of the study findings were based on an area under the receiver operating characteristic curve (AUROC) analysis, which revealed that CLIF-SOFA, CLIF-C ACLF, and CLIF-C AD scores were preferable to other models predicting 28-d mortality. Their AUROC scores were higher and able to predict all-cause mortality at 90, 180, and 365 d. A total of 50 articles were included in this study, which found that the CLIF-SOFA, CLIF-C ACLF and CLIF-C AD scores in more than half of the articles were able to predict short-term and long-term mortality in patients with either ACLF or AD. CONCLUSION CLIF-SOFA score surpasses other models in predicting mortality in ACLF patients, especially in the short-term. CLIF-SOFA, CLIF-C ACLF, and CLIF-C AD are accurate short-term and long-term mortality prognosticating scores.

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Predicting mortality for cirrhotic patients with acute oesophageal variceal haemorrhage using liver‐specific scores

Abstract: Previous presentation: Residency conclusion thesis for Alana Zulian Terres in 2018. Partial data presented as a poster presentation in Semana Brasileira do Aparelho Digestivo,

Cited by 7 publications

References 64 publications

Acute-on-Chronic Liver Failure Is Independently Associated With Lower Survival in Patients With Spontaneous Bacterial Peritonitis

Acute-on-Chronic Liver Failure Is Independently Associated With Lower Survival in Patients With Spontaneous Bacterial Peritonitis

Assessment of nomogram model for the prediction of esophageal variceal hemorrhage in hepatitis B-induced hepatic cirrhosis

CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review

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