Liver to abdominal area ratio in prognosis prediction in alcohol-induced acute-on-chronic liver failure

Abstract

To investigate the value of liver to abdominal area ratio (LAAR) in predicting prognosis of alcohol-induced acute-on-chronic liver failure (ACLF). The clinical data of patients with alcohol-induced ACLF admitted to the First Affiliated Hospital of Fujian Medical University from May 2008 to March 2015 were retrospectively analyzed. The primary outcome was death. The prognosis of the patients in 3 months after admission was followed up. The LAAR upon admission was calculated for each patient. The correlation between calculated liver volume and LAAR was explored. Cox proportional hazards model was used to explore the factors affecting the prognosis of the ACLF patients. Receiver operating characteristic (ROC) curve was drawn to determine the predictive value of LAAR in prognosis of the patients. Forty-five patients were included in this study, with 43 males and 2 females, and a median age of 48 years.Nineteen patients died with 3 months and 26 patients survived. Liver volume was positively correlated with LAAR (r=0.764, P<0.01). According to Cox analysis, LAAR (OR=1.067, 95% CI: 1.025-1.111, P=0.002) and model for end-stage liver disease (MELD) score (OR=1.103, 95% CI: 1.016-1.197, P=0.019) were independent prognostic factors for 3-months survival of alcohol-induced ACLF patients. The optimal cut-off value of LAAR for predicting survival was 44 (the area under the ROC curve was 0.747, 95% CI: 0.602-0.892, P=0.005). LAAR could serve as a new prognostic factor in alcohol-induced ACLF patients.