Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure
Standard
Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. / Jalan, Rajiv; Saliba, Faouzi; Pavesi, Marco; Amoros, Alex; Moreau, Richard; Ginès, Pere; Levesque, Eric; Durand, Francois; Angeli, Paolo; Caraceni, Paolo; Hopf, Corinna; Alessandria, Carlo; Rodriguez, Ezequiel; Solis-Muñoz, Pablo; Laleman, Wim; Trebicka, Jonel; Zeuzem, Stefan; Gustot, Thierry; Mookerjee, Rajeshwar; Elkrief, Laure; Soriano, German; Cordoba, Joan; Morando, Filippo; Gerbes, Alexander; Agarwal, Banwari; Samuel, Didier; Bernardi, Mauro; Arroyo, Vicente; CANONIC Study Investigators of the EASL–CLIF Consortium.
in: J HEPATOL, Jahrgang 61, Nr. 5, 01.11.2014, S. 1038-1047.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure
AU - Jalan, Rajiv
AU - Saliba, Faouzi
AU - Pavesi, Marco
AU - Amoros, Alex
AU - Moreau, Richard
AU - Ginès, Pere
AU - Levesque, Eric
AU - Durand, Francois
AU - Angeli, Paolo
AU - Caraceni, Paolo
AU - Hopf, Corinna
AU - Alessandria, Carlo
AU - Rodriguez, Ezequiel
AU - Solis-Muñoz, Pablo
AU - Laleman, Wim
AU - Trebicka, Jonel
AU - Zeuzem, Stefan
AU - Gustot, Thierry
AU - Mookerjee, Rajeshwar
AU - Elkrief, Laure
AU - Soriano, German
AU - Cordoba, Joan
AU - Morando, Filippo
AU - Gerbes, Alexander
AU - Agarwal, Banwari
AU - Samuel, Didier
AU - Bernardi, Mauro
AU - Arroyo, Vicente
AU - CANONIC Study Investigators of the EASL–CLIF Consortium
AU - Wege, Henning
AU - Benten, Daniel
AU - Lohse, Ansgar Wilhelm
N1 - Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - BACKGROUND & AIMS: 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.METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.
AB - BACKGROUND & AIMS: 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.METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.
U2 - 10.1016/j.jhep.2014.06.012
DO - 10.1016/j.jhep.2014.06.012
M3 - SCORING: Journal article
C2 - 24950482
VL - 61
SP - 1038
EP - 1047
JO - J HEPATOL
JF - J HEPATOL
SN - 0168-8278
IS - 5
ER -
