Robust Predictive Performance of the SALT‐M Score for Clinical Outcomes in Asian Patients With Acute‐on‐Chronic Liver Failure

ABSTRACT Background Acute‐on‐chronic liver failure (ACLF) is a syndrome of patients with chronic liver disease presenting with multiple organ failures. Recently, Sundaram‐ACLF‐LT Mortality (SALT‐M) score has been developed to predict 1‐year post‐liver transplantation mortality. We validated the SALT‐M score in a large‐volume, Asian single‐centre cohort. Aims We validated the SALT‐M score in a large‐volume, Asian single‐centre cohort. Methods We analysed 224 patients of ACLF grade 2–3. Area under the receiver operating characteristic curve (AUROC) and concordance index (c‐index) were used to assess and compare the predictability of posttransplant mortality of SALT‐M and other scores. Moreover, we compared the survivals of patients with high and low SALT‐M, in conjunction with MELD score and ACLF grade. Results The AUROC for prediction of 1‐year post‐LT survival was higher in SALT‐M (0.691) than in MELD, MELD‐Na, MELD 3.0 and delta‐MELD. Similarly, the c‐index of the SALT‐M (0.650) was higher than aforementioned MELD systems. When categorised by the cut‐off of SALT‐M ≥ 20 and MELD ≥ 30, patients with high SALT‐M exhibited lower post‐LT survival than those with low SALT‐M scores regardless of high or low MELD (40.0% for high SALT‐M/high MELD vs. 42.9% for high SALT‐M/low MELD vs. 73.8% for low SALT‐M/high MELD vs. 63.7% for low SALT‐M/low MELD, p