Comparison of Dynamic Changes Among Various Prognostic Scores in Viral Hepatitis-Related Acute Liver Failure
Journal Title: Annals of Hepatology - Year 2018, Vol 17, Issue 3
Abstract
Introduction and aim. Multiple prognostic scores are available for acute liver failure (ALF). Our objective was to compare the dynamicity of model for end stage liver disease (MELD), MELD-sodium, acute liver failure early dynamic model (ALFED), chronic liver failure (CLIF)-consortium ACLF score and King's College Hospital Criteria (KCH) for predicting outcome in ALF. Materials and methods. All consecutive patients with ALF at a tertiary care centre in India were included. MELD, MELD-Na, ALFED, CLIF-C ACLF scores and KCH criteria were calculated at admission and day 3 of admission. Area under receiver operator characteristic curves (AUROC) were compared with DeLong method. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR) and diagnostic accuracy (DA) were reported. Results. Of the 115 patients included in the study, 73 (63.5%) died. The discrimination of mortality with baseline values of prognostic scores (MELD, MELD-Na, ALFED, CLIF-C ACLF and KCH) was modest (AUROC: 0.65-0.77). The AUROC increased on day 3 for all scores, except KCH criteria. On day 3 of admission, ALFED score had the highest AUROC 0.95, followed by CLIF-C ACLF 0.88, MELD 0.81, MELD-Na 0.77 and KCH 0.52. The AUROC for ALFED was significantly higher than MELD, MELD-Na and KCH (P < 0.001 for all) and CLIF-C ACLF (P = 0.05). ALFED score ≥ 4 on day 3 had the best sensitivity (87.1%), specificity (89.5%), PPV (93.8%), NPV (79.1%), LR positive (8.3) and DA (87.9%) for predicting mortality. Conclusions. Dynamic assessment of prognostic scores better predicts outcome. ALFED model performs better than MELD, MELD, MELD-Na, CLIF-C ACLF scores and KCH criteria for predicting outcome in viral hepatitis- related ALF.<br/><br/>
Authors and Affiliations
Shalimar -, Ujjwal Sonika, Saurabh Kedia, Soumya J. Mahapatra, Baibaswata Nayak, Dawesh P. Yadav, Deepak Gunjan, Bhaskar Thakur, Harpreet Kaur, Subrat K. Acharya
Keywords
Related Articles
- EP ID EP345406
- DOI 10.5604/01.3001.0011.7384
- Views 116
- Downloads 0
Protective effect of four Mexican plants against CCl[sub]4[/sub]-induced damage on the Huh7 human hepatoma cell line
Background. Centaurea americana, Krameria ramosissima, Juglans mollis and Turnera diffusa are used by traditional healers in the northeastern region of Mexico to protect against liver damage. However, the hepatoprotectiv...
Should donation after cardiac death liver grafts be used for retransplantation?
Introduction. Donation after cardiac death (DCD) donors provide an important source of livers that has been used to expand the donor pool. As a consequence of increased numbers of OLT, allograft failure due to early and...
Prevalence and risk factors of isolated anti-HBc antibody and occult hepatitis B infection in hemodialysis patients: a nationwide study
[b]Background[/b]. Recent studies have demonstrated that prevention of hepatitis B virus (HBV) transmission remains a challenge in hemodialysis (HD) patients. The aim of this study is to explore factors which increase th...
Introductory message from the President of the Latin American Association or the Study of the Liver
Daclatasvir plus asunaprevir dual therapy for chronic HCV genotype 1b infection: results of Turkish early access program
Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries. Aim. To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy...