[ABC prognostic classification and MELD 3.0 and COSSH-ACLF â
¡ prognostic evaluation in acute-on-chronic liver failure].
Zhonghua Gan Zang Bing Za Zhi
; 30(9): 976-980, 2022 Sep 20.
Article
em Zh
| MEDLINE
| ID: mdl-36299192
ABSTRACT
Objective:
To investigate the ABC prognostic classification and the updated version of Model for End-stage Liver Disease (MELD) score 3.0 and Chinese Group on the Study of Severe Hepatitis B ACLF â ¡ score (COSSH-ACLF â ¡ score) to evaluate the prognostic value in acute-on-chronic liver failure (ACLF).Methods:
ABC classification was performed on a 1 409 follow-up cohorts. The area under the receiver operating characteristic curve (AUROC) was used to analyze MELD, MELD 3.0, COSSH-â ¡ and COSSH-â ¡ score after 3 days of hospitalization (COSSH-â ¡-3d). The prognostic predictive ability of patients were evaluated for 360 days, and the prediction differences of different classifications and different etiologies on the prognosis of ACLF were compared.Results:
The survival curve of 1 409 cases with ACLF showed that the difference between class A, B, and C was statistically significant, Log Rank (Mantel-Cox) χ2=80.133, P<0.01. Compared with class A and C, χ2=76.198, P<0.01, the difference between class B and C, was not statistically significant χ2=3.717, P>0.05. AUROC [95% confidence interval (CI)] analyzed MELD, MELD 3.0, COSSH-â ¡ and COSSH-â ¡-3d were 0.644, 0.655, 0.817 and 0.839, respectively (P<0.01). COSSH-â ¡ had better prognostic predictive ability with class A ACLF and HBV-related ACLF (HBV-ACLF) for 360-days, and AUROC (95% CI) were 0.877 and 0.881, respectively (P<0.01), while MELD 3.0 prognostic predictive value was not better than MELD.Conclusion:
ACLF prognosis is closely related to ABC classification. COSSH-â ¡ score has a high predictive value for the prognostic evaluation of class A ACLF and HBV-ACLF. COSSH-â ¡ score has a better prognostic evaluation value after 3 days of hospitalization, suggesting that attention should be paid to the treatment of ACLF in the early stage of admission.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença Hepática Terminal
/
Insuficiência Hepática Crônica Agudizada
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
Zh
Ano de publicação:
2022
Tipo de documento:
Article