The Prediction of In-Hospital Mortality in Decompensated Cirrhosis with Acute-on-Chronic Liver Failure
Copyright © 2021 American Association for the Study of Liver Diseases..
Acute-on-chronic liver failure (ACLF) is a condition in cirrhosis associated with organ failure (OF) and high short-term mortality. Both the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) and North American Consortium for the Study of End-Stage Liver Disease (NACSELD) ACLF definitions have been shown to predict ACLF prognosis. The aim of this study was to compare the ability of the EASL-CLIF versus NACSELD systems over baseline clinical and laboratory parameters in the prediction of in-hospital mortality in admitted patients with decompensated cirrhosis. Five NACSELD centers prospectively collected data to calculate EASL-CLIF and NACSELD-ACLF scores for admitted patients with cirrhosis who were followed for the development of OF, hospital course, and survival. Both the number of OFs and the ACLF grade or presence were used to determine the impact of NACSELD versus EASL-CLIF definitions of ACLF above baseline parameters on in-hospital mortality. A total of 1031 patients with decompensated cirrhosis (age, 57 ± 11 years; male, 66%; Child-Pugh-Turcotte score, 10 ± 2; Model for End-Stage Liver Disease [MELD] score, 20 ± 8) were enrolled. Renal failure prevalence (28% versus 9%, P < 0.001) was more common using the EASL-CLIF versus NACSELD definition, but the prevalence rates for brain, circulatory, and respiratory failures were similar. Baseline parameters including age, white cell count on admission, and MELD score reasonably predicted in-hospital mortality (area under the curve, 0.76). The addition of number of OFs according to either system did not improve the predictive power of the baseline parameters for in-hospital mortality, but the presence of NACSELD-ACLF did. However, neither system was better than baseline parameters in the prediction of 30- or 90-day outcomes. The presence of NACSELD-ACLF is equally effective as the EASL-CLIF ACLF grade, and better than baseline parameters in the prediction of in-hospital mortality in patients with cirrhosis, but not superior in the prediction of longer-term 30- or 90-day outcomes.
| Errataetall: |
CommentIn: Liver Transpl. 2022 Apr;28(4):544-546. - PMID 34919757 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
|---|---|
| Enthalten in: |
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society - 28(2022), 4 vom: 25. Apr., Seite 560-570 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wong, Florence [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 25.04.2022 Date Revised 09.05.2023 published: Print-Electronic CommentIn: Liver Transpl. 2022 Apr;28(4):544-546. - PMID 34919757 Citation Status MEDLINE |
|---|
| doi: |
10.1002/lt.26311 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM331065940 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM331065940 | ||
| 003 | DE-627 | ||
| 005 | 20231225212641.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/lt.26311 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1103.xml |
| 035 | |a (DE-627)NLM331065940 | ||
| 035 | |a (NLM)34564944 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wong, Florence |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Prediction of In-Hospital Mortality in Decompensated Cirrhosis with Acute-on-Chronic Liver Failure |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.04.2022 | ||
| 500 | |a Date Revised 09.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Liver Transpl. 2022 Apr;28(4):544-546. - PMID 34919757 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 American Association for the Study of Liver Diseases. | ||
| 520 | |a Acute-on-chronic liver failure (ACLF) is a condition in cirrhosis associated with organ failure (OF) and high short-term mortality. Both the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) and North American Consortium for the Study of End-Stage Liver Disease (NACSELD) ACLF definitions have been shown to predict ACLF prognosis. The aim of this study was to compare the ability of the EASL-CLIF versus NACSELD systems over baseline clinical and laboratory parameters in the prediction of in-hospital mortality in admitted patients with decompensated cirrhosis. Five NACSELD centers prospectively collected data to calculate EASL-CLIF and NACSELD-ACLF scores for admitted patients with cirrhosis who were followed for the development of OF, hospital course, and survival. Both the number of OFs and the ACLF grade or presence were used to determine the impact of NACSELD versus EASL-CLIF definitions of ACLF above baseline parameters on in-hospital mortality. A total of 1031 patients with decompensated cirrhosis (age, 57 ± 11 years; male, 66%; Child-Pugh-Turcotte score, 10 ± 2; Model for End-Stage Liver Disease [MELD] score, 20 ± 8) were enrolled. Renal failure prevalence (28% versus 9%, P < 0.001) was more common using the EASL-CLIF versus NACSELD definition, but the prevalence rates for brain, circulatory, and respiratory failures were similar. Baseline parameters including age, white cell count on admission, and MELD score reasonably predicted in-hospital mortality (area under the curve, 0.76). The addition of number of OFs according to either system did not improve the predictive power of the baseline parameters for in-hospital mortality, but the presence of NACSELD-ACLF did. However, neither system was better than baseline parameters in the prediction of 30- or 90-day outcomes. The presence of NACSELD-ACLF is equally effective as the EASL-CLIF ACLF grade, and better than baseline parameters in the prediction of in-hospital mortality in patients with cirrhosis, but not superior in the prediction of longer-term 30- or 90-day outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Reddy, K Rajender |e verfasserin |4 aut | |
| 700 | 1 | |a Tandon, Puneeta |e verfasserin |4 aut | |
| 700 | 1 | |a Lai, Jennifer C |e verfasserin |4 aut | |
| 700 | 1 | |a Jagarlamudi, Nishita |e verfasserin |4 aut | |
| 700 | 1 | |a Weir, Vanessa |e verfasserin |4 aut | |
| 700 | 1 | |a Kok, Beverley |e verfasserin |4 aut | |
| 700 | 1 | |a Kalainy, Sylvia |e verfasserin |4 aut | |
| 700 | 1 | |a Srisengfa, Yanin T |e verfasserin |4 aut | |
| 700 | 1 | |a Albhaisi, Somaya |e verfasserin |4 aut | |
| 700 | 1 | |a Reuter, Bradley |e verfasserin |4 aut | |
| 700 | 1 | |a Acharya, Chathur |e verfasserin |4 aut | |
| 700 | 1 | |a Shaw, Jawaid |e verfasserin |4 aut | |
| 700 | 1 | |a Thacker, Leroy R |e verfasserin |4 aut | |
| 700 | 1 | |a Bajaj, Jasmohan S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society |d 2000 |g 28(2022), 4 vom: 25. Apr., Seite 560-570 |w (DE-627)NLM105775185 |x 1527-6473 |7 nnns |
| 773 | 1 | 8 | |g volume:28 |g year:2022 |g number:4 |g day:25 |g month:04 |g pages:560-570 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/lt.26311 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 28 |j 2022 |e 4 |b 25 |c 04 |h 560-570 | ||