VALIDATION OF CLIF-C-ACLF SCORE FOR ALCOHOLIC LIVER CIRRHOSIS

Area of Science:

• Hepatology
• Internal Medicine
• Clinical Diagnostics

Background:

• Acute-on-chronic liver failure (ACLF) involves acute liver function deterioration in alcoholic cirrhosis (ALC) patients, often triggered by precipitating factors (PF) and leading to organ dysfunction.
• The CLIF-C-ACLF score quantifies organ/system decompensation and is recommended for ALC outcome prediction.

Purpose of the Study:

• To compare the diagnostic accuracy of the Child-Pugh score and the CLIF-C-ACLF score in predicting short-term mortality among ALC patients.
• To evaluate the scores' effectiveness in differentiating between chronic liver failure (CLF) and ACLF in ALC patients.

Main Methods:

• Retrospective analysis of clinical data from 150 ALC patients.
• Patients were categorized into two groups: CLF (without PF) and ACLF (with PF), with infectious complications defined as PF.
• Assessment of ALC severity and short-term mortality prediction using both Child-Pugh and CLIF-C-ACLF scores.

Main Results:

• The CLIF-C-ACLF score demonstrated significantly higher diagnostic value for predicting short-term mortality in both CLF and ACLF groups compared to the Child-Pugh score.
• In the CLF group, CLIF-C-ACLF showed 100% sensitivity and 93.75% specificity, while Child-Pugh had 100% sensitivity and 38.9% specificity.
• In the ACLF group, CLIF-C-ACLF exhibited 100% sensitivity and 88.5% specificity, outperforming Child-Pugh's 100% sensitivity and 29.5% specificity.
• The CLIF-C-ACLF score indicated excellent predictive quality (0.99 in CLF, 0.97 in ACLF), significantly exceeding the Child-Pugh score's performance (p = 0.012 and p = 0.015).

Conclusions:

• The CLIF-C-ACLF score is a more accurate tool than the Child-Pugh score for predicting short-term mortality in patients with alcoholic cirrhosis.
• The CLIF-C-ACLF score is particularly valuable for identifying high-risk patients experiencing acute decompensation of ALC due to precipitating factors.