Development and validation of a new prognostic score for hepatitis B virus-related acute-on-chronic liver failure

• DOI: 10.1016/j.jhep.2021.05.026
• Publication Date: 2021-06-04T21:32:33Z
• Authors: Jiaqi Li; Xi Liang; Shaoli You; Tingting Feng; Xin Zhou; Bing Zhu; Jinjin Luo; Jiaojiao Xin; Jing Jiang; Dongyan Shi; Yingyan Lu; Keke Ren; Tianzhou Wu; Lingling Yang; Jiang Li; Tan Li; Qun Cai; Suwan Sun; Beibei Guo; Xingping Zhou; Jiaxian Chen; Lulu He; Peng Li; Hui Yang; Wen Hu; Zhanglu An; Xiaojun Jin; Jin Tian; Baoju Wang; Xin Chen; Shaojie Xin; Jun Li
• Keywords: Hepatic Encephalopathy; Liver disease; Hepatitis B

Early determination of the prognosis patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is important to guide clinical management and decrease mortality. The aim this study was develop a new simplified prognostic score accurately predict outcomes in HBV-ACLF.Prospective data from 2,409 hospitalized acute deterioration HBV-related chronic disease were used that validated an external group.A total 954 enrolled HBV-ACLF diagnosed based on Chinese Group Study Severe Hepatitis B-ACLF (COSSH-ACLF) criteria. Six predictive factors significantly related 28-day mortality constituted (=1.649×ln(international normalized ratio)+0.457×hepatic encephalopathy score+0.425×ln(neutrophil)+0.396×ln(total bilirubin)+0.576×ln(serum urea)+0.033×age). C-indices for 28-/90-day (0.826/0.809) higher than those 4 other scores (COSSH-ACLF, 0.793/0.784; CLIF-C ACLF, 0.792/0.770; MELD, 0.731/0.727; MELD-Na, 0.730/0.726; all p <0.05). prediction error rates lower scores: COSSH-ACLF (15.9%), ACLF (16.3%), MELD (35.3%) MELD-Na (35.6%). probability density function evaluation risk stratification also showed highest values These results then cohort.A 6 predictors, without assessment organ failure, can short-term might be management.Hepatitis complex syndrome associated high rate. We developed suffering condition prospective multicentre cohort. This had better ability commonly scores.