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

  • 주제(키워드) acute-on-chronic liver failure , prognosis , validation
  • 주제(기타) Gastroenterology & Hepatology
  • 설명문(일반) [Song, Do Seon; Kim, Hee Yeon; Kim, Chang Wook; Yang, Jin Mo] Catholic Univ Korea, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Tae Yeob] Hanyang Univ, Inst Med Sci, Seoul, South Korea; [Sinn, Dong Hyun] Samsung Med Ctr, Dept Internal Med, Seoul, South Korea; [Yoon, Eileen L.] Inje Univ, Dept Internal Med, Sanggye Paik Hosp, Seoul, South Korea; [Choe, Won Hyeok] Konkuk Univ, Dept Internal Med, Sch Med, Seoul, South Korea; [Jang, Jae Young; Jeong, Soung Won] Soonchunhyang Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Hyoung Su] Hallym Univ, Dept Internal Med, Kangdong Sacred Heart Hosp, Seoul, South Korea; [Sinn, Dong Hyun; Suk, Ki Tae] Hallym Univ, Dept Internal Med, Coll Med, Chunchon, South Korea; [Jung, Young Kul; Yim, Hyung Joon] Korea Univ, Dept Internal Med, Ansan Hosp, Ansan, South Korea; [Lee, Sang Soo; Cho, Hyun Chin] Gyeongsang Natl Univ Hosp, Dept Internal Med, Jinju, South Korea; [Lee, Chang Hyeong] Catholic Univ Daegu, Dept Internal Med, Sch Med, Daegu, South Korea; [Kim, Sung Eun] Hallym Univ, Dept Internal Med, Sacred Heart Hosp, Anyang, South Korea; [Baik, Soon Koo] Yonsei Univ, Dept Internal Med, Wonju Coll Med, Wonju, South Korea; [Choi, Eun Hee] Yonsei Univ, Inst Lifestyle Med, Wonju Coll Med, Wonju, South Korea; [Kim, Sang Gyune] Soonchunhyang Univ, Dept Internal Med, Coll Med, Bucheon Hosp, Bucheon, South Korea; [Sohn, Joo Hyun] Hanyang Univ, Dept Internal Med, Guri Hosp, Guri, South Korea; [Kim, Tae Hun] Ewha Womans Univ, Dept Internal Med, Sch Med, Seoul, South Korea
  • 등재 SCIE, SCOPUS
  • 발행기관 WILEY
  • 발행년도 2018
  • URI http://www.dcollection.net/handler/ewha/000000151578
  • 본문언어 영어
  • Published As http://dx.doi.org/10.1111/jgh.13991

초록/요약

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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