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

On Behalf of the Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aim: The 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. Methods: Acute-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. Results: Among 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. Conclusions: The 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.

Original languageEnglish
Pages (from-to)900-909
Number of pages10
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume33
Issue number4
DOIs
Publication statusPublished - 2018 Apr 1

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Organ Dysfunction Scores
End Stage Liver Disease
Mortality
Research
ROC Curve
Acute-On-Chronic Liver Failure
Liver
Liver Diseases
Chronic Disease
Survival Rate

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

On Behalf of the Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group. / Validation of prognostic scores to predict short-term mortality in patients with acute-on-chronic liver failure. In: Journal of Gastroenterology and Hepatology (Australia). 2018 ; Vol. 33, No. 4. pp. 900-909.
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title = "Validation of prognostic scores to predict short-term mortality in patients with acute-on-chronic liver failure",
abstract = "Background and Aim: The 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. Methods: Acute-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. Results: Among 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. Conclusions: The 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.",
author = "{On Behalf of the Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group} and Song, {Do Seon} and Kim, {Tae Yeob} and Kim, {Dong Joon} and Kim, {Hee Yeon} and Sinn, {Dong Hyun} and Yoon, {Eileen L.} and Kim, {Chang Wook} and Jung, {Young Kul} and Suk, {Ki Tae} and Lee, {Sang Soo} and Lee, {Chang Hyeong} and Kim, {Tae Hun} and Choe, {Won Hyeok} and Yim, {Hyung Joon} and Kim, {Sung Eun} and Soonkoo Baik and Jang, {Jae Young} and Kim, {Hyoung Su} and Kim, {Sang Gyune} and Yang, {Jin Mo} and Sohn, {Joo Hyun} and Choi, {Eun Hee} and Cho, {Hyun Chin} and Jeong, {Soung Won} and Moonyoung Kim",
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Validation of prognostic scores to predict short-term mortality in patients with acute-on-chronic liver failure. / On Behalf of the Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 33, No. 4, 01.04.2018, p. 900-909.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Validation of prognostic scores to predict short-term mortality in patients with acute-on-chronic liver failure

AU - On Behalf of the Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group

AU - Song, Do Seon

AU - Kim, Tae Yeob

AU - Kim, Dong Joon

AU - Kim, Hee Yeon

AU - Sinn, Dong Hyun

AU - Yoon, Eileen L.

AU - Kim, Chang Wook

AU - Jung, Young Kul

AU - Suk, Ki Tae

AU - Lee, Sang Soo

AU - Lee, Chang Hyeong

AU - Kim, Tae Hun

AU - Choe, Won Hyeok

AU - Yim, Hyung Joon

AU - Kim, Sung Eun

AU - Baik, Soonkoo

AU - Jang, Jae Young

AU - Kim, Hyoung Su

AU - Kim, Sang Gyune

AU - Yang, Jin Mo

AU - Sohn, Joo Hyun

AU - Choi, Eun Hee

AU - Cho, Hyun Chin

AU - Jeong, Soung Won

AU - Kim, Moonyoung

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background and Aim: The 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. Methods: Acute-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. Results: Among 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. Conclusions: The 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.

AB - Background and Aim: The 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. Methods: Acute-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. Results: Among 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. Conclusions: The 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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U2 - 10.1111/jgh.13991

DO - 10.1111/jgh.13991

M3 - Article

VL - 33

SP - 900

EP - 909

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 4

ER -