Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Jalan, R; Saliba, F; Pavesi, M; Amoros, A; Moreau, R; Ginès, P; Levesque, E; Durand, F; Angeli, P; Caraceni, P; Hopf, C; Alessandria, C; Rodriguez, E; Solis-Muñoz, P; Laleman, W; Trebicka, J; Zeuzem, S; Gustot, T; Mookerjee, R; Elkrief, L; Soriano, G; Cordoba, J; Morando, F; Gerbes, A; Agarwal, B; Samuel, D; Bernardi, M; Arroyo, V; CANONIC study investigators of the EASL-CLIF Consortium.
Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure.
J Hepatol. 2014; 61(5): 1038-1047.
Doi: 10.1016/j.jhep.2014.06.012
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- Study Group Mitglieder der Med Uni Graz:
- Spindelböck Walter Johann
- Stauber Rudolf
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- Abstract:
- Acute-on-chronic liver failure (ACLF) is a frequent syndrome (30% prevalence), characterized by acute decompensation of cirrhosis, organ failure(s) and high short-term mortality. This study develops and validates a specific prognostic score for ACLF patients. Data from 1349 patients included in the CANONIC study were used. First, a simplified organ function scoring system (CLIF Consortium Organ Failure score, CLIF-C OFs) was developed to diagnose ACLF using data from all patients. Subsequently, in 275 patients with ACLF, CLIF-C OFs and two other independent predictors of mortality (age and white blood cell count) were combined to develop a specific prognostic score for ACLF (CLIF Consortium ACLF score [CLIF-C ACLFs]). A concordance index (C-index) was used to compare the discrimination abilities of CLIF-C ACLF, MELD, MELD-sodium (MELD-Na), and Child-Pugh (CPs) scores. The CLIF-C ACLFs was validated in an external cohort and assessed for sequential use. The CLIF-C ACLFs showed a significantly higher predictive accuracy than MELDs, MELD-Nas, and CPs, reducing (19-28%) the corresponding prediction error rates at all main time points after ACLF diagnosis (28, 90, 180, and 365 days) in both the CANONIC and the external validation cohort. CLIF-C ACLFs computed at 48 h, 3-7 days, and 8-15 days after ACLF diagnosis predicted the 28-day mortality significantly better than at diagnosis. The CLIF-C ACLFs at ACLF diagnosis is superior to the MELDs and MELD-Nas in predicting mortality. The CLIF-C ACLFs is a clinically relevant, validated scoring system that can be used sequentially to stratify the risk of mortality in ACLF patients. Copyright © 2014 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 - diagnosis Acute-On-Chronic Liver Failure - mortality
- Adult -
- Aged -
- Cohort Studies -
- Databases, Factual -
- Databases, Factual - epidemiology
- Female -
- Humans -
- Liver Cirrhosis - mortality
- Male -
- Middle Aged -
- Prognosis -
- Severity of Illness Index -
- Time Factors -
- Find related publications in this database (Keywords)
- Acute-on-chronic liver failure
- Cirrhosis
- Multi-organ failure
- Sepsis
- Prognosis