Comparison of Different Scores in Predicting Mortality in Patients with Acute on Chronic Liver Failure Admitted to the Intensive Care Unit of a Tertiary Care Hospital

Abstract

Background: The illness known as acute-on-chronic liver failure (ACLF) was just recently identified and characterized which is linked to morbidity and deaths. Several prognostic models are available to stratify these patients. Objective: The objective was to compare the performance of different non-invasive available models in predicting one-month and six months mortality in ACLF. Methods: This retrospective study included patients of age range 8-70 years of any gender having liver cirrhosis and fulfilling the criteria of ACLF from January 2019 to December 2022. The predesigned formula was used to calculate scores based on different models. The outcome was noted in terms of one month and six months of mortality in each patient. The receiver operative curve was constructed for six prognostic models available for predicting 30-day and six months mortality in ACLF patients. These scores were subjected to multivariable cox-regression analysis to determine the independent determinants of both short- and long-term mortality in ACLF patients. Results: A total of 235 patients were studied in this retrospective investigation. A one-month mortality rate of 78 patients (33.2%) and a six-month mortality rate of 155 patients (66%) were recorded, respectively. CTP score, MELD score, LBi, CLIF-SOFA, and CLIF-ACLF were independent predictors of one-month mortality on multivariate cox-regression analysis, but only CTP score, MELD score, and LBi were independent predictors of mortality at six months. Conclusion: Among the six prognostic scores used for the ICU-admitted ACLF patients, LBi was the most efficient predictor of both one-month and six months mortality while CLIF-C SOFA and CLIF ACLF were good predictors of both mortalities. CTP and MELD scores were useful in forecasting six months' mortality.