The scoring systems in predicting short-term outcomes in patients with hepatitis B virus-related acute-on-chronic...

Hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening syndrome characterized by acute and severe hepatic insults with high short-term mortality. This study aimed to compare the scoring systems which were used to predict short-term outcomes for HBV-ACLF patients.

A total of 529 patients diagnosed as HBV-ACLF were retrospectively analyzed and randomly divided, at a ratio of 3:1, into derivation cohort (n=397) and validation cohort (n=132). Univariate and multivariate analyses were performed to determine the discriminative abilities of the ALBI grade in predicting 30-day and 90-day mortality. The area under the receiver operating characteristic (AUC) curves was used to evaluate the accuracy of models.

The survival was associated with lower ALBI score, MELD score and CLIF-C ACLF score than death. In the derivation cohort, elevated ALBI score was related to worse prognosis (30-day mortality: HR =3.452; 90-day mortality: HR =3.822), increased MELD score was associated with worse overall survival (30- day mortality: HR =1.073; 90-day mortality: HR =1.082), and increased CLIF-C ACLF score was associated with worse overall survival (30-day mortality: HR =1.061; 90-day mortality: HR =1.065). The multivariate analyses identified the ALBI score, MELD score and CLIF-C ACLF score as independent prognostic predictors. The results of validation cohort validated these findings.

Our study revealed that both the ALBI score, MELD score and CLIF-C ACLF score could predict 30- and 90-day mortality of HBV-ACLF accurately. Elevated ALBI score, MELD score and CLIF-C ACLF score were associated with worse prognosis.