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Conference Paper: The prognostic stratification using acute-on-chronic liver failure scoring system for predicting short-term mortality in patients with alcoholic hepatitis

TitleThe prognostic stratification using acute-on-chronic liver failure scoring system for predicting short-term mortality in patients with alcoholic hepatitis
Authors
Issue Date2018
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0
Citation
27th Annual Conference of Asian Pacific Association for the Study of the Liver (APASL), New Delhi, India, 14-18 March 2018. In Hepatology International, 2018, v. 12 n. Suppl. 2, p. S195-S196 How to Cite?
AbstractBackground: To compare the existing various prognostic scoring models and newly proposed scores for acute-on-chronic liver failure (ACLF) and evaluate usefulness of stratification for the prediction of short-term morality in patients with alcoholic hepatitis (AH). Method: A total of 708 clinical AH patients, enrolled in the APASLACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. AARC-ACLF score, Maddrey discrimination function (DF) score, age, bilirubin, international normalized ratio and creatinine score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), Child-Turcott-Pugh (CTP) score, model for end-stage liver disease (MELD), and MELD-Sodium (Na) scores were used to compare the performance for predicting 30-day and 90-day mortality. AARC-ACLF scores were categorized into three grades (Gr I: 5-7; II: 8-10; and III: 11-15 points) and survival curves by the Kaplan-Meier method were created and compared using log-rank test. Result: Of 708 patients, 286 (40.4%) and 363 (51.3%) patients died within 30 days and 90 days, respectively. The area under receiver operating characteristics curve (AUC) of AARC-ACLF, DF, ABIC, GAHS, CTP, MELD, and MELD-Na was 0.752 (0.705-0.799), 0.630 (0.575-0.685), 0.658 (0.604-0.711), 0.577 (0.523-0.631), 0.641 (0.589-0.694), 0.705 (0.653-0.756), 0.703 (0.651-0.755), respectively, for 30-day mortality. The AUC of various prognostic scores for the prediction of 90-day mortality is similar. The performance of AARCACLF was superior to that of DF, ABIC, GAHS, CTP, while comparable to that of MELD and MELD-Na in predicting short-term mortality. According to AARC-ACLF grades, short-term cumulative survivals was statistically different (30-day, 82.4, 70.4, and 35.3%, p\0.001; 90-day, 76.9, 56.0, and 26.4%, p\0.001). Conclusion: Compared to the previous AH prognostic scores, AARC-ACLF score and grades are simple and useful for predicting the short-term mortality in patients with AH. Further studies are needed to confirm these implications.
Persistent Identifierhttp://hdl.handle.net/10722/261986
ISSN
2017 Impact Factor: 4.117
2015 SCImago Journal Rankings: 0.669

 

DC FieldValueLanguage
dc.contributor.authorKim, DJ-
dc.contributor.authorKim, TK-
dc.contributor.authorChoudhury, AK-
dc.contributor.authorJia, JD-
dc.contributor.authorJain, P-
dc.contributor.authorPaulson, I-
dc.contributor.authorAl Mahtab, AI-
dc.contributor.authorRahman, S-
dc.contributor.authorDevarbhavi, H-
dc.contributor.authorDuan, ZP-
dc.contributor.authorChen, Y-
dc.contributor.authorEapen, CE-
dc.contributor.authorGoel, A-
dc.contributor.authorNing, Q-
dc.contributor.authorLau, GK-
dc.contributor.authorRao, PN-
dc.contributor.authorAlcantarapayawal, D-
dc.contributor.authorDokmeci, AK-
dc.contributor.authorYuen, RMF-
dc.contributor.authorPrasad, VGN-
dc.contributor.authorYokosuka, O-
dc.contributor.authorPrasad, AS-
dc.date.accessioned2018-09-28T04:51:27Z-
dc.date.available2018-09-28T04:51:27Z-
dc.date.issued2018-
dc.identifier.citation27th Annual Conference of Asian Pacific Association for the Study of the Liver (APASL), New Delhi, India, 14-18 March 2018. In Hepatology International, 2018, v. 12 n. Suppl. 2, p. S195-S196-
dc.identifier.issn1936-0533-
dc.identifier.urihttp://hdl.handle.net/10722/261986-
dc.description.abstractBackground: To compare the existing various prognostic scoring models and newly proposed scores for acute-on-chronic liver failure (ACLF) and evaluate usefulness of stratification for the prediction of short-term morality in patients with alcoholic hepatitis (AH). Method: A total of 708 clinical AH patients, enrolled in the APASLACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. AARC-ACLF score, Maddrey discrimination function (DF) score, age, bilirubin, international normalized ratio and creatinine score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), Child-Turcott-Pugh (CTP) score, model for end-stage liver disease (MELD), and MELD-Sodium (Na) scores were used to compare the performance for predicting 30-day and 90-day mortality. AARC-ACLF scores were categorized into three grades (Gr I: 5-7; II: 8-10; and III: 11-15 points) and survival curves by the Kaplan-Meier method were created and compared using log-rank test. Result: Of 708 patients, 286 (40.4%) and 363 (51.3%) patients died within 30 days and 90 days, respectively. The area under receiver operating characteristics curve (AUC) of AARC-ACLF, DF, ABIC, GAHS, CTP, MELD, and MELD-Na was 0.752 (0.705-0.799), 0.630 (0.575-0.685), 0.658 (0.604-0.711), 0.577 (0.523-0.631), 0.641 (0.589-0.694), 0.705 (0.653-0.756), 0.703 (0.651-0.755), respectively, for 30-day mortality. The AUC of various prognostic scores for the prediction of 90-day mortality is similar. The performance of AARCACLF was superior to that of DF, ABIC, GAHS, CTP, while comparable to that of MELD and MELD-Na in predicting short-term mortality. According to AARC-ACLF grades, short-term cumulative survivals was statistically different (30-day, 82.4, 70.4, and 35.3%, p\0.001; 90-day, 76.9, 56.0, and 26.4%, p\0.001). Conclusion: Compared to the previous AH prognostic scores, AARC-ACLF score and grades are simple and useful for predicting the short-term mortality in patients with AH. Further studies are needed to confirm these implications.-
dc.languageeng-
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0-
dc.relation.ispartofHepatology International-
dc.relation.ispartofAsian Pacific Association for the Study of the Liver (APASL) Annual Conference-
dc.titleThe prognostic stratification using acute-on-chronic liver failure scoring system for predicting short-term mortality in patients with alcoholic hepatitis-
dc.typeConference_Paper-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.authorityYuen, RMF=rp00479-
dc.identifier.hkuros293116-
dc.identifier.volume12-
dc.identifier.issueSuppl. 2-
dc.identifier.spageS195-
dc.identifier.epageS196-
dc.publisher.placeUnited States-

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