PROGNOSTIC ABILITY OF DIFFERENT SCORING SYSTEMS TO PREDICT VERY EARLY MORTALITY IN PATIENTS WITH CIRRHOSIS AND ACUTE-ON-CHRONIC LIVER FAILURE (ACLF)

Introduction and Objectives

ACLF is characterized by acute deterioration of liver function with significant systemic inflammation and high long-term mortality. The aim of this work is to validate the prognostic ability of different scoring systems to predict very early mortality (7 days) in Mexican patients with cirrhosis and ACLF.

Materials and Methods

An observational, retrospective, descriptive, analytical and cohort study was performed. Forty patients with diagnosis of ACLF were included. The different prognostic scores such as MELD, MELD 3.0, CLIF-C ACLF, CLIF-C OF and AARC ACLF were calculated. ROC curves were constructed and the area under the curve was evaluated for each prognostic scale looking for the best sensitivity and specificity to predict very early 7-day mortality. An area under the curve greater than .075 and a value of p<0.01 were considered optimal.

Results

Forty patients with cirrhosis were included, mean age 49.95±10.68 (29.02-70.88), 27 (68%) were men, the main reason for admission was hepatic encephalopathy in 18 patients (45%), the most common ACLF grade was grade 2 (45%), 33 patients (85%) were admitted with some degree of acute kidney injury, the average days of hospital stay were 11. 85±6.59 (-1.07-24.77) and the total number of deaths was 22 (55%). The AUROC of the scales are shown in Figure 1.

Conclusions

CLIF C OF appears to be the best predictor scoring system for very early mortality in the first seven days of hospitalization in patients with ACLF.

Conflict of interest: None

Area under the curve of different scales for predicting very early mortality (7 Days) in patients with ACLF