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

Hee Yeon Kim, Chang Wook Kim, Tae Yeob Kim, Do Seon Song, Dong Hyun Sinn, Eileen L. Yoon, Young Kul Jung, Ki Tae Suk, Sang Soo Lee, Chang Hyeong Lee, Tae Hun Kim, Jeong Han Kim, Hyung Joon Yim, Sung Eun Kim, Soon Koo Baik, Byung Seok Lee, Jae Young Jang, Young Seok Kim, Sang Gyune Kim, Jin Mo YangJoo Hyun Sohn, Heon Ju Lee, Seung Ha Park, Eun Hee Choi, Dong Joon Kim

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19 Scopus citations


AIM To assess the performance of proposed scores specific for acute-on-chronic liver failure in predicting shortterm 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 Failure- Sequential Organ Failure Assessment (CLIF-SOFA), CLIF Consortium Organ Failure score (CLIF-C OFs), Maddrey's discriminant 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.

Original languageEnglish
Pages (from-to)9205-9213
Number of pages9
JournalWorld Journal of Gastroenterology
Issue number41
StatePublished - 7 Nov 2016

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  • Acute-on-chronic liver failure
  • Alcoholic hepatitis
  • Mortality
  • Prognosis
  • Scoring system


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