Tags

Type your tag names separated by a space and hit enter

Single-centre validation of the EASL-CLIF consortium definition of acute-on-chronic liver failure and CLIF-SOFA for prediction of mortality in cirrhosis.
Liver Int. 2015 May; 35(5):1516-23.LI

Abstract

BACKGROUND & AIMS

The idea of acute-on-chronic liver failure (ACLF) has emerged to identify those subjects with organ failure and high mortality rates. However, the absence of a precise definition has limited the clinical application and research related to the ACLF concept. We sought to validate the ACLF definition and the CLIF-SOFA Score recently proposed by the EASL-CLIF Consortium in a cohort of patients admitted for acute decompensation (AD) of cirrhosis.

METHODS

In this prospective cohort study, patients were followed during their hospital stay and thirty and 90-day mortality was evaluated by phone call, in case of hospital discharge. All subjects underwent laboratory evaluation at admission.

RESULTS

Between December 2010 and November 2013, 192 cirrhotic patients were included. At enrollment, 46 patients (24%) met the criteria for ACLF (Grades 1, 2 and 3 in 18%, 4% and 2% respectively). The 30-day mortality was 65% in ACLF group and 12% in the remaining subjects (P < 0.001). Logistic regression analysis showed that 30-day mortality was independently associated with ascites and ACLF at admission. The Kaplan-Meier survival probability at 90-day was 92% in patients without ascites or ACLF and only 22% for patients with both ascites and ACLF. The AUROC of CLIF-SOFA in predicting 30-day mortality was 0.847 ± 0.034, with sensitivity of 64%, specificity of 90% and positive likelihood ratio of 6.61 for values ≥9.

CONCLUSION

In our single-centre experience the CLIF-SOFA and the EASL-CLIF Consortium definition of ACLF proved to be strong predictors of short-term mortality in cirrhotic patients admitted for AD.

Authors+Show Affiliations

Division of Gastroenterology, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

24840673

Citation

Silva, Pedro E Soares E., et al. "Single-centre Validation of the EASL-CLIF Consortium Definition of Acute-on-chronic Liver Failure and CLIF-SOFA for Prediction of Mortality in Cirrhosis." Liver International : Official Journal of the International Association for the Study of the Liver, vol. 35, no. 5, 2015, pp. 1516-23.
Silva PE, Fayad L, Lazzarotto C, et al. Single-centre validation of the EASL-CLIF consortium definition of acute-on-chronic liver failure and CLIF-SOFA for prediction of mortality in cirrhosis. Liver Int. 2015;35(5):1516-23.
Silva, P. E., Fayad, L., Lazzarotto, C., Ronsoni, M. F., Bazzo, M. L., Colombo, B. S., Dantas-Correa, E. B., Narciso-Schiavon, J. L., & Schiavon, L. L. (2015). Single-centre validation of the EASL-CLIF consortium definition of acute-on-chronic liver failure and CLIF-SOFA for prediction of mortality in cirrhosis. Liver International : Official Journal of the International Association for the Study of the Liver, 35(5), 1516-23. https://doi.org/10.1111/liv.12597
Silva PE, et al. Single-centre Validation of the EASL-CLIF Consortium Definition of Acute-on-chronic Liver Failure and CLIF-SOFA for Prediction of Mortality in Cirrhosis. Liver Int. 2015;35(5):1516-23. PubMed PMID: 24840673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Single-centre validation of the EASL-CLIF consortium definition of acute-on-chronic liver failure and CLIF-SOFA for prediction of mortality in cirrhosis. AU - Silva,Pedro E Soares E, AU - Fayad,Leonardo, AU - Lazzarotto,César, AU - Ronsoni,Marcelo F, AU - Bazzo,Maria L, AU - Colombo,Bruno S, AU - Dantas-Correa,Esther B, AU - Narciso-Schiavon,Janaína L, AU - Schiavon,Leonardo L, Y1 - 2014/06/06/ PY - 2014/02/27/received PY - 2014/05/13/accepted PY - 2014/5/21/entrez PY - 2014/5/21/pubmed PY - 2016/1/15/medline KW - acute decompensation KW - acute-on-chronic liver failure KW - cirrhosis KW - organ failure SP - 1516 EP - 23 JF - Liver international : official journal of the International Association for the Study of the Liver JO - Liver Int. VL - 35 IS - 5 N2 - BACKGROUND & AIMS: The idea of acute-on-chronic liver failure (ACLF) has emerged to identify those subjects with organ failure and high mortality rates. However, the absence of a precise definition has limited the clinical application and research related to the ACLF concept. We sought to validate the ACLF definition and the CLIF-SOFA Score recently proposed by the EASL-CLIF Consortium in a cohort of patients admitted for acute decompensation (AD) of cirrhosis. METHODS: In this prospective cohort study, patients were followed during their hospital stay and thirty and 90-day mortality was evaluated by phone call, in case of hospital discharge. All subjects underwent laboratory evaluation at admission. RESULTS: Between December 2010 and November 2013, 192 cirrhotic patients were included. At enrollment, 46 patients (24%) met the criteria for ACLF (Grades 1, 2 and 3 in 18%, 4% and 2% respectively). The 30-day mortality was 65% in ACLF group and 12% in the remaining subjects (P < 0.001). Logistic regression analysis showed that 30-day mortality was independently associated with ascites and ACLF at admission. The Kaplan-Meier survival probability at 90-day was 92% in patients without ascites or ACLF and only 22% for patients with both ascites and ACLF. The AUROC of CLIF-SOFA in predicting 30-day mortality was 0.847 ± 0.034, with sensitivity of 64%, specificity of 90% and positive likelihood ratio of 6.61 for values ≥9. CONCLUSION: In our single-centre experience the CLIF-SOFA and the EASL-CLIF Consortium definition of ACLF proved to be strong predictors of short-term mortality in cirrhotic patients admitted for AD. SN - 1478-3231 UR - https://www.unboundmedicine.com/medline/citation/24840673/Single_centre_validation_of_the_EASL_CLIF_consortium_definition_of_acute_on_chronic_liver_failure_and_CLIF_SOFA_for_prediction_of_mortality_in_cirrhosis_ L2 - https://doi.org/10.1111/liv.12597 DB - PRIME DP - Unbound Medicine ER -