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

Authors
Song, Do SeonKim, Tae YeobKim, Dong JoonKim, Hee YeonSinn, Dong HyunYoon, Eileen L.Kim, Chang WookJung, Young KulSuk, Ki TaeLee, Sang SooLee, Chang HyeongKim, Tae HunChoe, Won HyeokYim, Hyung JoonKim, Sung EunBaik, Soon KooJang, Jae YoungKim, Hyoung SuKim, Sang GyuneYang, Jin MoSohn, Joo HyunChoi, Eun HeeCho, Hyun ChinJeong, Soung WonKim, Moon Young
Issue Date
4월-2018
Publisher
WILEY
Keywords
acute-on-chronic liver failure; prognosis; validation
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.33, no.4, pp.900 - 909
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume
33
Number
4
Start Page
900
End Page
909
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/76262
DOI
10.1111/jgh.13991
ISSN
0815-9319
Abstract
Background and AimThe aim of this study was to validate the chronic liver failure-sequential organ failure assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score in Korean chronic liver disease patients with acute deterioration. MethodsAcute-on-chronic liver failure was defined by either the Asian Pacific Association for the study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria. The diagnostic performances for short-term mortality were compared by the area under the receiver operating characteristic curve. ResultsAmong a total of 1470 patients, 252 patients were diagnosed with ACLF according to the CLIF-C (197 patients) or AARC definition (95 patients). As the ACLF grades increased, the survival rates became significantly lower. The areas under the receiver operating characteristic of the CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs were significantly higher than those of the Child-Pugh, model for end-stage liver disease, and model for end-stage liver disease-Na scores in ACLF patients according to the CLIF-C definition (all P<0.05), but there were no significant differences in patients without ACLF or in patients with ACLF according to the AARC definition. The CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs had higher specificities with a fixed sensitivity than liver specific scores in ACLF patients according to the CLIF-C definition, but not in ACLF patients according to the AARC definition. ConclusionsThe 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.
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