HINT: a novel prognostic model for patients with hepatitis B virus‐related acute‐on‐chronic liver failure

Summary Background HBV‐related acute‐on‐chronic liver failure (HBV‐ACLF) deteriorates rapidly in the short term, which necessitates accurate initial clinical decision making. Aims To develop a novel prognostic score for patients with HBV‐ACLF and clarify the role of thyroid hormones in HBV‐ACLF. Methods A retrospective cohort of 635 HBV‐ACLF patients was enrolled to develop and validate a novel prognostic score for HBV‐ACLF. Additionally, a cross‐sectional cohort (n = 199) and a prospective longitudinal HBV‐ACLF cohort (n = 56) were recruited to clarify the association between thyroid hormone status and the 30‐day mortality of HBV‐ACLF. Results HINT, a novel prognostic score based on hepatic encephalopathy, INR, neutrophil count, and thyroid‐stimulating hormone (TSH) using the deriving cohort (n = 426), was significantly higher in non‐survivors than survivors (1.17 ± 2.38 vs −1.87 ± 1.26, P