Comparison of five different scoring models for predicting short-term mortality in patients with alcohol-related acute-on-chronic liver failure

Abstract

AIM To compare the performance of age,bilirubin,INR,and creatinine(ABIC),Maddrey’s discriminant function(MDF),model for end-stage liver disease(MELD),chronic liver failure-sequential organ failure assessment(CLIF-SOFA),and Child-Turcotte-Pugh(CTP) in predicting short-term mortality in patients with alcohol-related acute-on-chronic liver failure(ACLF).METHODS There were 462 consecutive patients with live failure treated from August 2005 to June 2017 at Tianjin Third Central Hospital,of whom 152 with alcohol-related ACLF were finally enrolled in this study according to the inclusion criteria and exclusion criteria.We divided patients into either group A or group B.Patients in group A met the criteria of Asian Pacific Association for the Study of the Liver but did not met the criteria of European Association for the Study of the LiverChronic Liver Failure(EASL-CLIF),and patients in group B met the criteria of EASL-CLIF on admission.The performance of different scoring models in predicting short-term mortality was assessed using the area under the receiver operating characteristic curve(AUC-ROC).RESULTS The 28-d mortality rate was 19% in group A and 50% in group B(P = 0.002).In group A,the AUC of CLIFSOFA for predicting the 28-d mortality was highest(0.889),followed by MELD(0.761),MDF(0.738),ABIC(0.718),and CTP(0.671),and the rewas a significant difference between CTP and the others.In group B,the AUC of CLIF-SOFA was 0.916,followed by MELD(0.804),MDF(0.770),ABIC(0.729),and CTP(0.647),and there was a signifi cant difference between CLIF-SOFA and the others and between CTP and the others.CONCLUSION The five scoring systems could all predict the shortterm prognosis of the two groups of patients.However,CLIF-SOFA performs well compared to the others,regardless of patients in group A or group B.