ALTA: a simple nutritional prognostic score for patients with hepatitis B virus-related acute-on-chronic liver failure

被引:0
作者
Song, Rui [1 ]
Wang, Xiaohao [1 ]
Li, Zhao [2 ]
Wu, Hongyu [3 ]
Tan, Jiahe [4 ]
Tan, Junyi [5 ]
Li, Hanlu [5 ]
Zeng, Teng [6 ]
Ren, Hong [1 ]
Chen, Zhiwei [1 ]
机构
[1] Chongqing Med Univ, Affiliated Hosp 2, Key Lab Mol Biol Infect Dis,Dept Infect Dis, Chinese Minist Educ,Inst Viral Hepatitis, Chongqing, Peoples R China
[2] Seventh Peoples Hosp Chongqing, Dept Gastroenterol, Chongqing, Peoples R China
[3] Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 2, Chongqing, Peoples R China
[4] Chongqing Med Univ, Dept Neurosurg, Affiliated Hosp 1, Chongqing, Peoples R China
[5] Ninth Peoples Hosp Chongqing, Dept Infect Dis, Chongqing, Peoples R China
[6] Fifth Peoples Hosp Chongqing, Dept Infect Dis, Chongqing, Peoples R China
来源
FRONTIERS IN NUTRITION | 2024年 / 11卷
关键词
acute-on-chronic liver failure; hepatitis B virus; prognostic score; nutrition; mortality; VALIDATION; MORTALITY;
D O I
10.3389/fnut.2024.1370025
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background Malnutrition, despite being a common complication, is often neglected in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The objective of this study was to develop a simplified nutritional prognostic score to accurately predict mortality in HBV-ACLF patients. Methods In this multicenter retrospective study, clinical data from 530 HBV-ACLF patients were used to create a new prognostic score, which was then validated in two external cohorts (n = 229 and 248). Results Four independent factors were significantly associated with 28-day mortality in HBV-ACLF patients, forming a novel prognostic score (ALTA score = 0.187 x age-0.849 x lymphocyte count-2.033 x total cholesterol-0.148 x albumin-0.971). Notably, the AUROC of ALTA score for 28/90-day mortality (0.950/0.967) were significantly higher than those of three other ACLF prognostic scores (COSSH-ACLF II, 0.864/0.734; MELD, 0.525/0.488; MELD-Na, 0.546/0.517; all P < 0.001), and three known nutritional scores (CONUT, 0.739/0.861; OPNI, 0.279/0.157; NRS-2002, 0.322/0.286; all P < 0.001). The prediction error rates of ALTA score for 28-day mortality were significantly lower than COSSH-ACLF II (7.3%), MELD (14.4%), MELD-Na (12.7%), CONUT (9.0%), OPNI (30.6%), and NRS2002 (34.1%) scores. Further classifying ALTA score into two strata, the hazard ratios of mortality at 28/90 days were notably increased in the high-risk groups compared to the low-risk group (15.959 and 5.740). These results were then validated in two external cohorts. Conclusion ALTA, as a simplified nutritional prognostic score for HBV-ACLF, demonstrates superiority over the COSSH-ACLF II and other scores in predicting short-term mortality among HBV-ACLF patients. Therefore, it may be used to guide clinical management, particularly in primary care settings.
引用
收藏
页数:11
相关论文
共 50 条
  • [41] The scoring systems in predicting short-term outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure
    Li, Hui
    Zheng, Jun
    Chen, Liang
    Cai, Jianye
    Zhang, Min
    Wang, Genshu
    [J]. ANNALS OF PALLIATIVE MEDICINE, 2020, 9 (05) : 3048 - +
  • [42] Low Serum Soluble Transferrin Receptor Levels Are Associated with Poor Prognosis in Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure
    Yang, Kai
    Pan, Ying
    Jin, Lei
    Yu, Furong
    Zhang, Fasu
    [J]. BIOLOGICAL TRACE ELEMENT RESEARCH, 2023, 201 (06) : 2757 - 2764
  • [43] Clinical Features of Hepatitis C Virus-related Acute-on-chronic Liver Failure in a Korean Population
    Choi, Jung Woo
    Kwak, Ji Yoon
    Lee, Sang Soo
    Kim, Hyun-gyu
    Son, Ho Jin
    Jeon, Hankyu
    Kim, Hee Jin
    Cha, Ra Ri
    Lee, Jae Min
    Kim, Hyun Jin
    [J]. KOREAN JOURNAL OF GASTROENTEROLOGY, 2022, 80 (04) : 169 - +
  • [44] A Novel Prognostic Score for Acute-on-Chronic Hepatitis B Liver Failure
    易钊泉
    鲁猛厚
    徐旭雯
    符小玉
    谭德明
    [J]. Current Medical Science, 2015, (01) : 87 - 92
  • [45] A novel prognostic score for acute-on-chronic hepatitis B liver failure
    Yi, Zhao-quan
    Lu, Meng-hou
    Xu, Xu-wen
    Fu, Xiao-yu
    Tan, De-ming
    [J]. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY-MEDICAL SCIENCES, 2015, 35 (01) : 87 - 92
  • [46] A novel prognostic score for acute-on-chronic hepatitis B liver failure
    Zhao-quan Yi
    Meng-hou Lu
    Xu-wen Xu
    Xiao-yu Fu
    De-ming Tan
    [J]. Journal of Huazhong University of Science and Technology [Medical Sciences], 2015, 35 : 87 - 92
  • [47] Clinical Prediction Models for Hepatitis B Virus-related Acute-on-chronic Liver Failure: A Technical Report
    Yu, Xia
    Lu, Yi
    Sun, Shanshan
    Tu, Huilan
    Xu, Xianbin
    Gong, Kai
    Yao, Junjie
    Shi, Yu
    Sheng, Jifang
    [J]. JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY, 2021, 9 (06) : 838 - 849
  • [48] Dynamic changes of T cell receptor repertoires in patients with hepatitis B virus-related acute-on-chronic liver failure
    Shen, Guojun
    Sun, Shuilin
    Huang, Jie
    Deng, Haohui
    Xu, Ying
    Wang, Zhanhui
    Tang, Xiong
    Gong, Xiaodong
    [J]. HEPATOLOGY INTERNATIONAL, 2020, 14 (01) : 47 - 56
  • [49] Dynamic changes of T cell receptor repertoires in patients with hepatitis B virus-related acute-on-chronic liver failure
    Guojun Shen
    Shuilin Sun
    Jie Huang
    Haohui Deng
    Ying Xu
    Zhanhui Wang
    Xiong Tang
    Xiaodong Gong
    [J]. Hepatology International, 2020, 14 : 47 - 56
  • [50] Prognostic Value of Complete Blood Cell Count-Derived Inflammatory Markers in Hepatitis B Virus-Related Acute-on-Chronic Liver Failure
    Liu, Xiao-Yun
    He, Xia
    Cai, Ming
    Peng, Song-Qing
    [J]. CLINICAL LABORATORY, 2021, 67 (10) : 2347 - 2353