Assessment of scoring systems for acute-on-chronic liver failure at predicting short-term mortality in patients with alcoholic hepatitis

被引：14

作者：

Kim, Hee Yeon ^{[1
]}

Kim, Chang Wook ^{[1
]}

Kim, Tae Yeob ^{[2
]}

Song, Do Seon ^{[1
]}

Sinn, Dong Hyun ^{[3
]}

Yoon, Eileen L. ^{[4
]}

Jung, Young Kul ^{[5
]}

Suk, Ki Tae ^{[6
]}

Lee, Sang Soo ^{[7
]}

Lee, Chang Hyeong ^{[8
]}

Kim, Tae Hun ^{[9
]}

Kim, Jeong Han ^{[10
]}

Yim, Hyung Joon ^{[5
]}

Kim, Sung Eun ^{[11
]}

Baik, Soon Koo ^{[12
]}

Lee, Byung Seok ^{[13
]}

Jang, Jae Young ^{[14
]}

Kim, Young Seok ^{[15
]}

Kim, Sang Gyune ^{[15
]}

Yang, Jin Mo ^{[1
]}

Sohn, Joo Hyun ^{[16
]}

Lee, Heon Ju ^{[17
]}

Park, Seung Ha ^{[18
]}

Choi, Eun Hee ^{[19
]}

Kim, Dong Joon ^{[6
]}

机构：

[1] Catholic Univ Korea, Coll Med, Dept Internal Med, Seoul 06591, South Korea

[2] Hanyang Univ, Inst Med Sci, Seoul 04763, South Korea

[3] Samsung Med Ctr, Dept Internal Med, Seoul 06351, South Korea

[4] Inje Univ, Sanggye Paik Hosp, Dept Internal Med, Seoul 01757, South Korea

[5] Korea Univ, Ansan Hosp, Dept Internal Med, Ansan 15355, South Korea

[6] Hallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Sakju Ro 77,200-704, Chunchon 24253, South Korea

[7] Gyeongsang Natl Univ Hosp, Dept Internal Med, Jinju 52727, South Korea

[8] Catholic Univ Daegu, Sch Med, Dept Internal Med, Daegu 42472, South Korea

[9] Ewha Womans Univ, Sch Med, Dept Internal Med, Seoul 07985, South Korea

[10] Konkuk Univ, Sch Med, Dept Internal Med, Seoul 05030, South Korea

[11] Hallym Univ, Sacred Heart Hosp, Dept Internal Med, Anyang 14068, South Korea

[12] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Wonju 26426, South Korea

[13] Chungnam Natl Univ, Sch Med, Dept Internal Med, Daejeon 35015, South Korea

[14] Soonchunhyang Univ, Coll Med, Dept Internal Med, Seoul 04401, South Korea

[15] Soonchunhyang Univ, Bucheon Hosp, Dept Internal Med, Bucheon 14584, South Korea

[16] Hanyang Univ, Guri Hosp, Dept Internal Med, Guri 11923, South Korea

[17] Yeungnam Univ, Coll Med, Dept Internal Med, Daegu 42415, South Korea

[18] Inje Univ, Coll Med, Haeundae Paik Hosp, Dept Internal Med, Busan 48108, South Korea

[19] Yonsei Univ, Wonju Coll Med, Inst Lifestyle Med, Wonju 26426, South Korea

来源：

WORLD JOURNAL OF GASTROENTEROLOGY | 2016年 / 22卷 / 41期

关键词：

Acute-on-chronic liver failure; Alcoholic hepatitis; Mortality; Prognosis; Scoring system; CORTICOSTEROID-THERAPY; MELD SCORE; VALIDATION; SURVIVAL; MODEL; DIAGNOSIS; PROGNOSIS; DISEASE; TRIALS; BIOPSY;

D O I：

10.3748/wjg.v22.i41.9205

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

AIM To assess the performance of proposed scores specific for acute-on-chronic liver failure in predicting short-term mortality among patients with alcoholic hepatitis. METHODS We retrospectively collected data from 264 patients with clinically diagnosed alcoholic hepatitis from January to December 2013 at 21 academic hospitals in Korea. The performance for predicting short-term mortality was calculated for Chronic Liver FailureSequential Organ Failure Assessment (CLIF-SOFA), CLIF Consortium Organ Failure score (CLIF-C OFs), Maddrey'sdiscriminant function (DF), age, bilirubin, international normalized ratio and creatinine score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), model for end-stage liver disease (MELD), and MELD-Na. RESULTS Of 264 patients, 32 (12%) patients died within 28 d. The area under receiver operating characteristic curve of CLIF-SOFA, CLIF-C OFs, DF, ABIC, GAHS, MELD, and MELD-Na was 0.86 (0.81-0.90), 0.89 (0.84-0.92), 0.79 (0.74-0.84), 0.78 (0.72-0.83), 0.81 (0.76-0.86), 0.83 (0.78-0.88), and 0.83 (0.78-0.88), respectively, for 28-d mortality. The performance of CLIF-SOFA had no statistically significant differences for 28-d mortality. The performance of CLIF-C OFs was superior to that of DF, ABIC, and GAHS, while comparable to that of MELD and MELD-Na in predicting 28-d mortality. A CLIF-SOFA score of 8 had 78.1% sensitivity and 79.7% specificity, and CLIF-C OFs of 10 had 68.8% sensitivity and 91.4% specificity for predicting 28-d mortality. CONCLUSION CLIF-SOFA and CLIF-C OF scores performed well, with comparable predictive ability for short-term mortality compared to the commonly used scoring systems in patients with alcoholic hepatitis.

引用

页码：9205 / 9213

页数：9

共 31 条

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