Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF
BACKGROUND In the intensive care unit (ICU), critically ill patients with cirrhosis and acute-on-chronic liver failure (ACLF) continue to have high mortality rates. The AARC ACLF score is a simple, newly-developed score based on Asian ACLF patients, which performs well in prognosis. The present stud...
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| Veröffentlicht in: | Medical science monitor 2020-09, Vol.26, p.e926574-e926574 |
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| creator | Lin, Xinran Huang, Xielin Wang, Li Feng, Shuyi Chen, Xiaofu Cai, Weimin Huang, Zhiming |
| description | BACKGROUND In the intensive care unit (ICU), critically ill patients with cirrhosis and acute-on-chronic liver failure (ACLF) continue to have high mortality rates. The AARC ACLF score is a simple, newly-developed score based on Asian ACLF patients, which performs well in prognosis. The present study attempted to verify the prognostic ability of AARC ACLF in non-Asian critically ill patients with cirrhosis and ACLF. MATERIAL AND METHODS We enrolled 786 patients. Relevant clinical data were collected within 24 h after admission to compare the differences between survivors and non-survivors, and all the patients were followed up for at least 180 days. RESULTS The 28-day, 90-day, and 180-day mortality rates were 28.9% (227/786), 36.4% (286/786), and 40.3% (317/786), respectively. Multivariate Cox regression analysis showed that AARC ACLF score (HR: 1.375, 95% CI: 1.247-1.516, P |
| doi_str_mv | 10.12659/MSM.926574 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7526342</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2446671327</sourcerecordid><originalsourceid>FETCH-LOGICAL-c381t-f91b3930e905babbb123c7aa127ea5f0b1e64cf33b91a9cfce95414c1f7e8af43</originalsourceid><addsrcrecordid>eNpVUU1LAzEUDKL4ffIuOSqyNV-7aS5CWawKFQU_riGbJjaSbjTZrfTfG20VPb15zLx5AwPAEUYDTKpSnN8-3A5ERpxtgF1cMVpQXqLNP3gH7KX0ihAZVqjcBjuUCD4UtNoF8T6Glzakzmn4rHxvYLBwpPvOFHdtUc9iaDMzcQsT4Vg530cDT0b1ZHwKH3TIi2thHV0-V94v4Y338F51zrRdgh-um8HaxTgLySWo2in8ujwAW1b5ZA7Xcx88jS8f6-ticnd1U48mhaZD3BVW4IYKioxAZaOapsGEaq4UJtyo0qIGm4ppS2kjsBLaaiNKhpnGlpuhsozug4uV71vfzM1U50xRefkW3VzFpQzKyf9M62byJSwkL0lFGckGJ2uDGN57kzo5d0kb71VrQp8kYayqOKaEZ-nZSqpjSCka-_sGI_ndkswtyVVLWX38N9mv9qcW-glfhY4W</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2446671327</pqid></control><display><type>article</type><title>Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Lin, Xinran ; Huang, Xielin ; Wang, Li ; Feng, Shuyi ; Chen, Xiaofu ; Cai, Weimin ; Huang, Zhiming</creator><creatorcontrib>Lin, Xinran ; Huang, Xielin ; Wang, Li ; Feng, Shuyi ; Chen, Xiaofu ; Cai, Weimin ; Huang, Zhiming</creatorcontrib><description>BACKGROUND In the intensive care unit (ICU), critically ill patients with cirrhosis and acute-on-chronic liver failure (ACLF) continue to have high mortality rates. The AARC ACLF score is a simple, newly-developed score based on Asian ACLF patients, which performs well in prognosis. The present study attempted to verify the prognostic ability of AARC ACLF in non-Asian critically ill patients with cirrhosis and ACLF. MATERIAL AND METHODS We enrolled 786 patients. Relevant clinical data were collected within 24 h after admission to compare the differences between survivors and non-survivors, and all the patients were followed up for at least 180 days. RESULTS The 28-day, 90-day, and 180-day mortality rates were 28.9% (227/786), 36.4% (286/786), and 40.3% (317/786), respectively. Multivariate Cox regression analysis showed that AARC ACLF score (HR: 1.375, 95% CI: 1.247-1.516, P<0.001) was an independent predictive factor of 28-day mortality, and the AUROC of the predictive ability in 28-day mortality of the AARC ACLF score was 0.754. In addition, the AARC ACLF score was regraded into 3 classes (low risk: AARC ACLF <9, intermediate risk: 9≤ AARC ACLF <12, and high risk: AARC ACLF ≥12). The AARC ACLF score can be used for dynamic assessment by retest at days 4-7. CONCLUSIONS The AARC ACLF score has a good predictive value for 28-day, 90-day, and 180-day mortality in non-Asian critically ill patients with cirrhosis and ACLF, which is not inferior to CLIF-C ACLFsLact and other models. It is easy to use at bedside, and it is dynamic and reliable.</description><identifier>ISSN: 1643-3750</identifier><identifier>ISSN: 1234-1010</identifier><identifier>EISSN: 1643-3750</identifier><identifier>DOI: 10.12659/MSM.926574</identifier><identifier>PMID: 32978936</identifier><language>eng</language><publisher>United States: International Scientific Literature, Inc</publisher><subject>Acute-On-Chronic Liver Failure - mortality ; Acute-On-Chronic Liver Failure - pathology ; Acute-On-Chronic Liver Failure - therapy ; Adult ; Aged ; Aged, 80 and over ; Critical Illness ; Database Analysis ; Disease-Free Survival ; Female ; Humans ; Liver Cirrhosis - mortality ; Liver Cirrhosis - pathology ; Liver Cirrhosis - therapy ; Male ; Middle Aged ; Models, Biological ; Retrospective Studies ; Severity of Illness Index ; Survival Rate</subject><ispartof>Medical science monitor, 2020-09, Vol.26, p.e926574-e926574</ispartof><rights>Med Sci Monit, 2020 2020</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-f91b3930e905babbb123c7aa127ea5f0b1e64cf33b91a9cfce95414c1f7e8af43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526342/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526342/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32978936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Xinran</creatorcontrib><creatorcontrib>Huang, Xielin</creatorcontrib><creatorcontrib>Wang, Li</creatorcontrib><creatorcontrib>Feng, Shuyi</creatorcontrib><creatorcontrib>Chen, Xiaofu</creatorcontrib><creatorcontrib>Cai, Weimin</creatorcontrib><creatorcontrib>Huang, Zhiming</creatorcontrib><title>Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF</title><title>Medical science monitor</title><addtitle>Med Sci Monit</addtitle><description>BACKGROUND In the intensive care unit (ICU), critically ill patients with cirrhosis and acute-on-chronic liver failure (ACLF) continue to have high mortality rates. The AARC ACLF score is a simple, newly-developed score based on Asian ACLF patients, which performs well in prognosis. The present study attempted to verify the prognostic ability of AARC ACLF in non-Asian critically ill patients with cirrhosis and ACLF. MATERIAL AND METHODS We enrolled 786 patients. Relevant clinical data were collected within 24 h after admission to compare the differences between survivors and non-survivors, and all the patients were followed up for at least 180 days. RESULTS The 28-day, 90-day, and 180-day mortality rates were 28.9% (227/786), 36.4% (286/786), and 40.3% (317/786), respectively. Multivariate Cox regression analysis showed that AARC ACLF score (HR: 1.375, 95% CI: 1.247-1.516, P<0.001) was an independent predictive factor of 28-day mortality, and the AUROC of the predictive ability in 28-day mortality of the AARC ACLF score was 0.754. In addition, the AARC ACLF score was regraded into 3 classes (low risk: AARC ACLF <9, intermediate risk: 9≤ AARC ACLF <12, and high risk: AARC ACLF ≥12). The AARC ACLF score can be used for dynamic assessment by retest at days 4-7. CONCLUSIONS The AARC ACLF score has a good predictive value for 28-day, 90-day, and 180-day mortality in non-Asian critically ill patients with cirrhosis and ACLF, which is not inferior to CLIF-C ACLFsLact and other models. It is easy to use at bedside, and it is dynamic and reliable.</description><subject>Acute-On-Chronic Liver Failure - mortality</subject><subject>Acute-On-Chronic Liver Failure - pathology</subject><subject>Acute-On-Chronic Liver Failure - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Critical Illness</subject><subject>Database Analysis</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Liver Cirrhosis - mortality</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver Cirrhosis - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Biological</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><issn>1643-3750</issn><issn>1234-1010</issn><issn>1643-3750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1LAzEUDKL4ffIuOSqyNV-7aS5CWawKFQU_riGbJjaSbjTZrfTfG20VPb15zLx5AwPAEUYDTKpSnN8-3A5ERpxtgF1cMVpQXqLNP3gH7KX0ihAZVqjcBjuUCD4UtNoF8T6Glzakzmn4rHxvYLBwpPvOFHdtUc9iaDMzcQsT4Vg530cDT0b1ZHwKH3TIi2thHV0-V94v4Y338F51zrRdgh-um8HaxTgLySWo2in8ujwAW1b5ZA7Xcx88jS8f6-ticnd1U48mhaZD3BVW4IYKioxAZaOapsGEaq4UJtyo0qIGm4ppS2kjsBLaaiNKhpnGlpuhsozug4uV71vfzM1U50xRefkW3VzFpQzKyf9M62byJSwkL0lFGckGJ2uDGN57kzo5d0kb71VrQp8kYayqOKaEZ-nZSqpjSCka-_sGI_ndkswtyVVLWX38N9mv9qcW-glfhY4W</recordid><startdate>20200926</startdate><enddate>20200926</enddate><creator>Lin, Xinran</creator><creator>Huang, Xielin</creator><creator>Wang, Li</creator><creator>Feng, Shuyi</creator><creator>Chen, Xiaofu</creator><creator>Cai, Weimin</creator><creator>Huang, Zhiming</creator><general>International Scientific Literature, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200926</creationdate><title>Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF</title><author>Lin, Xinran ; Huang, Xielin ; Wang, Li ; Feng, Shuyi ; Chen, Xiaofu ; Cai, Weimin ; Huang, Zhiming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-f91b3930e905babbb123c7aa127ea5f0b1e64cf33b91a9cfce95414c1f7e8af43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute-On-Chronic Liver Failure - mortality</topic><topic>Acute-On-Chronic Liver Failure - pathology</topic><topic>Acute-On-Chronic Liver Failure - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Critical Illness</topic><topic>Database Analysis</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Liver Cirrhosis - mortality</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver Cirrhosis - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Biological</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><toplevel>online_resources</toplevel><creatorcontrib>Lin, Xinran</creatorcontrib><creatorcontrib>Huang, Xielin</creatorcontrib><creatorcontrib>Wang, Li</creatorcontrib><creatorcontrib>Feng, Shuyi</creatorcontrib><creatorcontrib>Chen, Xiaofu</creatorcontrib><creatorcontrib>Cai, Weimin</creatorcontrib><creatorcontrib>Huang, Zhiming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medical science monitor</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Xinran</au><au>Huang, Xielin</au><au>Wang, Li</au><au>Feng, Shuyi</au><au>Chen, Xiaofu</au><au>Cai, Weimin</au><au>Huang, Zhiming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF</atitle><jtitle>Medical science monitor</jtitle><addtitle>Med Sci Monit</addtitle><date>2020-09-26</date><risdate>2020</risdate><volume>26</volume><spage>e926574</spage><epage>e926574</epage><pages>e926574-e926574</pages><issn>1643-3750</issn><issn>1234-1010</issn><eissn>1643-3750</eissn><abstract>BACKGROUND In the intensive care unit (ICU), critically ill patients with cirrhosis and acute-on-chronic liver failure (ACLF) continue to have high mortality rates. The AARC ACLF score is a simple, newly-developed score based on Asian ACLF patients, which performs well in prognosis. The present study attempted to verify the prognostic ability of AARC ACLF in non-Asian critically ill patients with cirrhosis and ACLF. MATERIAL AND METHODS We enrolled 786 patients. Relevant clinical data were collected within 24 h after admission to compare the differences between survivors and non-survivors, and all the patients were followed up for at least 180 days. RESULTS The 28-day, 90-day, and 180-day mortality rates were 28.9% (227/786), 36.4% (286/786), and 40.3% (317/786), respectively. Multivariate Cox regression analysis showed that AARC ACLF score (HR: 1.375, 95% CI: 1.247-1.516, P<0.001) was an independent predictive factor of 28-day mortality, and the AUROC of the predictive ability in 28-day mortality of the AARC ACLF score was 0.754. In addition, the AARC ACLF score was regraded into 3 classes (low risk: AARC ACLF <9, intermediate risk: 9≤ AARC ACLF <12, and high risk: AARC ACLF ≥12). The AARC ACLF score can be used for dynamic assessment by retest at days 4-7. CONCLUSIONS The AARC ACLF score has a good predictive value for 28-day, 90-day, and 180-day mortality in non-Asian critically ill patients with cirrhosis and ACLF, which is not inferior to CLIF-C ACLFsLact and other models. It is easy to use at bedside, and it is dynamic and reliable.</abstract><cop>United States</cop><pub>International Scientific Literature, Inc</pub><pmid>32978936</pmid><doi>10.12659/MSM.926574</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Acute-On-Chronic Liver Failure - mortality Acute-On-Chronic Liver Failure - pathology Acute-On-Chronic Liver Failure - therapy Adult Aged Aged, 80 and over Critical Illness Database Analysis Disease-Free Survival Female Humans Liver Cirrhosis - mortality Liver Cirrhosis - pathology Liver Cirrhosis - therapy Male Middle Aged Models, Biological Retrospective Studies Severity of Illness Index Survival Rate |
| title | Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF |
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