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- Title
CLIF- SOFA scoring system accurately predicts short-term mortality in acutely decompensated patients with alcoholic cirrhosis: a retrospective analysis.
- Authors
Lee, Minjong; Lee, Jeong ‐ Hoon; Oh, Sohee; Jang, Yoonhyuk; Lee, Wonik; Lee, Hyung Joo; Yoo, Jeong ‐ ju; Choi, Won ‐ Mook; Cho, Young Youn; Cho, Yuri; Lee, Dong Hyeon; Lee, Yun Bin; Yu, Su Jong; Yi, Nam ‐ Joon; Lee, Kwang ‐ Woong; Kim, Yoon Jun; Yoon, Jung ‐ Hwan; Suh, Kyung ‐ Suk; Lee, Hyo ‐ Suk
- Abstract
Background & Aims Accurate prognostication of acute-on-chronic liver failure ( ACLF) is essential for therapeutic decisions. Our aim was to validate a novel scoring system for predicting mortality, the chronic liver failure-sequential organ failure assessment ( CLIF- SOFA), in a population of Asian patients with ACLF. Methods A total of 345 patients with acutely decompensated alcoholic cirrhosis were selected for study, comparing areas under the receiver operating characteristic ( AUROC) curves of CLIF- SOFA and five existing scoring systems for end-stage liver disease [model for end-stage liver disease ( MELD), MELD-Na, Refit- MELD, Refit- MELD-Na, and Child-Turcotte-Pugh]. Results CLIF- SOFA displayed the highest AUROC of 0.943 significantly outperforming all five reference methods in predicting short-term mortality at Week 4 (all P < 0.001) by competing risk analysis. In 262 patients given supportive care only, the power of CLIF- SOFA to predict short-term mortality was high ( AUROC: 0.952 at Week 1; 0.959 at Week 4), again surpassing the other methods (all P < 0.001). For the remaining 83 liver transplant recipients, CLIF- SOFA also excelled in predicting 12-week mortality ( AUROC: 0.978); and high-grade ACLF by CLIF- SOFA was associated with prolonged postoperative mechanical support (i.e. mechanical ventilation and renal replacement therapy) and ICU stays (all P < 0.05). Conclusions CLIF- SOFA enables more accurate prediction of short-term mortality in patients with acutely decompensated alcoholic cirrhosis than other available scoring systems and is useful in predicting both 12-week mortality and the need for mechanical support after liver transplantation.
- Subjects
LIVER failure; LIVER diseases; MORTALITY; CIRRHOSIS of the liver; BILIARY liver cirrhosis
- Publication
Liver International, 2015, Vol 35, Issue 1, p46
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.12683