Prognostic performance of clinical indices and model scorings for acute‑on‑chronic liver failure: A study of 164 patients

  • Authors:
    • Qianqian Zhang
    • Xiaolin Guo
    • Shixing Zhao
    • Xiaoli Pang
    • Yang Wang
    • Yujiao Zhang
    • Baorong Chi
  • View Affiliations

  • Published online on: January 29, 2016     https://doi.org/10.3892/etm.2016.3037
  • Pages: 1348-1354
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Abstract

The present study aimed to analyze the prognostic factors of acute‑on‑chronic liver failure (ACLF), with the perspective of an improved selection of optimal therapeutic schemes. A retrospective analysis was used to study 164 patients with ACLF hospitalized between 2010 and 2014 in a single center. Patients were divided into favorable and unfavorable groups, according to the treatment outcomes. General characteristics and clinical manifestations were analyzed to determine whether they would affect the prognosis of the patients with ACLF, with a particular focus on the scoring systems Child‑Pugh, model for end‑stage liver disease (MELD), MELD with incorporation of sodium (MELD‑Na), MELD and serum sodium ratio (MESO) and integrated MELD (iMELD). Hepatitis B virus infection was the predominant cause of ACLF, accounting for 88 cases (53.7%). Age, prothrombin time, thrombin time, international normalized ratio (INR), prothrombin activity, serum sodium, albumin, total bilirubin, serum creatinine, platelets, fasting blood sugar, infections, hepatic encephalopathy, hepatorenal syndrome (HRS), and electrolyte disorder were revealed to be associated with prognosis. Age, serum sodium, INR, HRS, and infection were independent prognostic risk factors, as determined by multivariate analysis. Child‑Pugh, MELD, MELD‑Na, MESO and iMELD scoring systems all demonstrated adequate predictive values, with MELD‑Na as the most effective scoring system. In conclusion, age, hyponatremia, INR, HRS and bacterial or fungal infections were reported to be independent prognostic risk factors for ACLF. Among the various liver function scoring systems, MELD‑Na was the most accurate in predicting the prognosis of ACLF.
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April-2016
Volume 11 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Zhang Q, Guo X, Zhao S, Pang X, Wang Y, Zhang Y and Chi B: Prognostic performance of clinical indices and model scorings for acute‑on‑chronic liver failure: A study of 164 patients. Exp Ther Med 11: 1348-1354, 2016
APA
Zhang, Q., Guo, X., Zhao, S., Pang, X., Wang, Y., Zhang, Y., & Chi, B. (2016). Prognostic performance of clinical indices and model scorings for acute‑on‑chronic liver failure: A study of 164 patients. Experimental and Therapeutic Medicine, 11, 1348-1354. https://doi.org/10.3892/etm.2016.3037
MLA
Zhang, Q., Guo, X., Zhao, S., Pang, X., Wang, Y., Zhang, Y., Chi, B."Prognostic performance of clinical indices and model scorings for acute‑on‑chronic liver failure: A study of 164 patients". Experimental and Therapeutic Medicine 11.4 (2016): 1348-1354.
Chicago
Zhang, Q., Guo, X., Zhao, S., Pang, X., Wang, Y., Zhang, Y., Chi, B."Prognostic performance of clinical indices and model scorings for acute‑on‑chronic liver failure: A study of 164 patients". Experimental and Therapeutic Medicine 11, no. 4 (2016): 1348-1354. https://doi.org/10.3892/etm.2016.3037