Development of a Widely Applicable and Simple Prognostic Score for Patients with Acute-on-chronic Liver Failure

作     者：Zhenjun Yu Yu Zhang Yuhan Li Feng Zhou Manman Xu Shaoli You Yu Chen Bing Zhu Ming Kong Fangjiao Song Shaojie Xin Zhongping Duan Tao Han China Network for Severe Liver Diseases 

作者机构：Department of Hepatology and GastroenterologyThe Third Central Clinical College of Tianjin Medical UniversityTianjinChina Liver Disease Center(Difficult and Complicated Liver Diseases and Artificial Liver Center)Beijing You’an Hospital Affiliated to Capital Medical UniversityBeijingChina Liver Failure Treatment and Research CenterThe Fifth Medical Center of Chinese PLA General HospitalBeijingChina Department of Gastroenterology and HepatologyTianjin Union Medical Center Affiliated to Nankai UniversityTianjinChina 不详 

出 版 物：《Journal of Clinical and Translational Hepatology》 (临床与转化肝病杂志（英文版）)

年 卷 期：2022年第10卷第5期

页      面：867-878页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported primarily by research grants from the National 13th 5-Year Plan for Hepatitis Research(No.2017ZX10203201-007) the National Natural Science Foundation of China(No.81870429,82170630) the Natural Science Foundation of Tianjin(No.19JCZDJC36700) 

主　　题：Acute-on-chronic liver failure Scoring model Trends Prognosis 

摘      要：Background and Aims:Acute-on-chronic liver failure(ACLF)tends to progress rapidly with high short-term *** aimed to create a widely applicable,simple prognostic(WASP)score for ACLF ***:A retrospective cohort of ACLF cases recruited from three centers in China were divided into training and validation sets to develop the new score.A prospective longitudinal cohort was recruited for further ***:A total of 541 cases were included in the training set,and seven independent ACLF prognostic factors were screened to construct a new quantitative WASP-ACLF *** the validation set of 671 cases,WASP-ACLF showed better predictive ability for 28-day and 90-day mortality than the currently used prognostic scores at baseline,day 3,week 1,and week *** predictive efficacy and clinical validity of the model improved over *** were assigned to low-,intermediate-,and high-risk groups by their WASP-ACLF *** with the other two groups,intermediate-risk patients had a more uncertain prognosis,with a 90-day mortality of 44.4–50.6%.Sequential assessments at weeks 1 and 2 found the 90-day mortality of intermediate-risk groups was20%forpatients with a≥2 point decrease in WASP-ACLF and was up to 56%for patients with a≥2 points *** results were observed in prospective ***:The new ACLF prognostic score was simple,widely applicable,and had good predictive *** assessments and trend of change in WASP-ACLF need to be considered,especially for intermediate-risk patients.