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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Jalan, R; Pavesi, M; Saliba, F; Amorós, A; Fernandez, J; Holland-Fischer, P; Sawhney, R; Mookerjee, R; Caraceni, P; Moreau, R; Ginès, P; Durand, F; Angeli, P; Alessandria, C; Laleman, W; Trebicka, J; Samuel, D; Zeuzem, S; Gustot, T; Gerbes, AL; Wendon, J; Bernardi, M; Arroyo, V; CANONIC Study Investigators; EASL-CLIF Consortium.
The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure.
J Hepatol. 2015; 62(4):831-840
Doi: 10.1016/j.jhep.2014.11.012
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- Spindelböck Walter Johann
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- Abstract:
- Cirrhotic patients with acute decompensation frequently develop acute-on-chronic liver failure (ACLF), which is associated with high mortality rates. Recently, a specific score for these patients has been developed using the CANONIC study database. The aims of this study were to develop and validate the CLIF-C AD score, a specific prognostic score for hospitalised cirrhotic patients with acute decompensation (AD), but without ACLF, and to compare this with the Child-Pugh, MELD, and MELD-Na scores. The derivation set included 1016 CANONIC study patients without ACLF. Proportional hazards models considering liver transplantation as a competing risk were used to identify score parameters. Estimated coefficients were used as relative weights to compute the CLIF-C ADs. External validation was performed in 225 cirrhotic AD patients. CLIF-C ADs was also tested for sequential use. Age, serum sodium, white-cell count, creatinine and INR were selected as the best predictors of mortality. The C-index for prediction of mortality was better for CLIF-C ADs compared with Child-Pugh, MELD, and MELD-Nas at predicting 3- and 12-month mortality in the derivation, internal validation and the external dataset. CLIF-C ADs improved in its ability to predict 3-month mortality using data from days 2, 3-7, and 8-15 (C-index: 0.72, 0.75, and 0.77 respectively). The new CLIF-C ADs is more accurate than other liver scores in predicting prognosis in hospitalised cirrhotic patients without ACLF. CLIF-C ADs therefore may be used to identify a high-risk cohort for intensive management and a low-risk group that may be discharged early. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute-On-Chronic Liver Failure -
- Adult -
- Aged -
- Creatinine - blood
- Disease Progression -
- Female -
- Hospitalization - statistics & numerical data
- Humans -
- International Normalized Ratio -
- Leukocyte Count -
- Liver Cirrhosis - diagnosis
- Liver Cirrhosis - mortality
- Liver Cirrhosis - physiopathology
- Liver Cirrhosis - therapy
- Male -
- Middle Aged -
- Predictive Value of Tests -
- Prognosis -
- Reproducibility of Results -
- Research Design - standards
- Risk Assessment - methods
- Sodium - blood
- Survival Analysis -
- Find related publications in this database (Keywords)
- Acute-on-chronic liver failure
- Hepatic encephalopathy
- Chronic liver failure