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Simple organ failure count versus CANONIC grading system for predicting mortality in acute-on-chronic liver failure.
J Gastroenterol Hepatol. 2015 Mar; 30(3):575-81.JG

Abstract

BACKGROUND AND AIM

This study assessed the utility of a simple organ failure count (SOFC) in predicting the in-hospital mortality in patients with acute-on-chronic liver failure (ACLF) compared with Chronic Liver Failure Acute-on-Chronic Liver Failure in Cirrhosis (CANONIC) ACLF grading system.

METHODS

Consecutive patients of ACLF were included prospectively from 2012 to 2013. The diagnosis was based on Asian-Pacific Association for the Study of the Liver (APASL) criteria except for the inclusion of non-hepatic insults as acute events. Organ failures were defined as per the Chronic Liver Failure-Sequential Organ Failure Assessment system. SOFC was calculated as the simple number of organ failures from 0 to 6. In-hospital mortality was recorded.

RESULTS

Majority (92[87%]) of the 106 patients included were males, had alcohol (76[72%]) as the etiology of cirrhosis, and alcoholic hepatitis (58[55%]) as the acute precipitating event. Overall, 51(48%) patients died in-hospital. In-hospital mortality in patients with SOFC of 0 (n = 9), 1 (n = 39), 2 (n = 24), 3 (n = 24), 4 (n = 7), and 5 (n = 3) was 0%, 26%, 58%, 71%, 100%, and 100% respectively (P < 0.001), whereas it was 10%, 30%, 58%, and 79% in patients with no-ACLF (n = 21), grades 1 (n = 27), 2 (n = 24), and 3 ACLF (n = 34) respectively (P < 0.001). Patients with no-ACLF (n = 21) had higher mortality than SOFC 0 as they included 9 patients with SOFC 0 (0% mortality) and 12 patients with SOFC 1 (17% mortality). Mortality was similar between 12 no-ACLF and 27 grade 1 ACLF patients (P = 0.462) that comprised SOFC 1.

CONCLUSION

SOFC is a simpler and better method than the CANONIC grading system for predicting the in-hospital mortality in patients with ACLF defined as per APASL criteria.

Authors+Show Affiliations

Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25251968

Citation

Agrawal, Swastik, et al. "Simple Organ Failure Count Versus CANONIC Grading System for Predicting Mortality in Acute-on-chronic Liver Failure." Journal of Gastroenterology and Hepatology, vol. 30, no. 3, 2015, pp. 575-81.
Agrawal S, Duseja A, Gupta T, et al. Simple organ failure count versus CANONIC grading system for predicting mortality in acute-on-chronic liver failure. J Gastroenterol Hepatol. 2015;30(3):575-81.
Agrawal, S., Duseja, A., Gupta, T., Dhiman, R. K., & Chawla, Y. (2015). Simple organ failure count versus CANONIC grading system for predicting mortality in acute-on-chronic liver failure. Journal of Gastroenterology and Hepatology, 30(3), 575-81. https://doi.org/10.1111/jgh.12778
Agrawal S, et al. Simple Organ Failure Count Versus CANONIC Grading System for Predicting Mortality in Acute-on-chronic Liver Failure. J Gastroenterol Hepatol. 2015;30(3):575-81. PubMed PMID: 25251968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simple organ failure count versus CANONIC grading system for predicting mortality in acute-on-chronic liver failure. AU - Agrawal,Swastik, AU - Duseja,Ajay, AU - Gupta,Tarana, AU - Dhiman,Radha K, AU - Chawla,Yogesh, PY - 2014/09/07/accepted PY - 2014/9/25/entrez PY - 2014/9/25/pubmed PY - 2015/9/22/medline KW - ACLF KW - acute decompensation KW - cirrhosis KW - mortality KW - organ failure KW - prognosis SP - 575 EP - 81 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 30 IS - 3 N2 - BACKGROUND AND AIM: This study assessed the utility of a simple organ failure count (SOFC) in predicting the in-hospital mortality in patients with acute-on-chronic liver failure (ACLF) compared with Chronic Liver Failure Acute-on-Chronic Liver Failure in Cirrhosis (CANONIC) ACLF grading system. METHODS: Consecutive patients of ACLF were included prospectively from 2012 to 2013. The diagnosis was based on Asian-Pacific Association for the Study of the Liver (APASL) criteria except for the inclusion of non-hepatic insults as acute events. Organ failures were defined as per the Chronic Liver Failure-Sequential Organ Failure Assessment system. SOFC was calculated as the simple number of organ failures from 0 to 6. In-hospital mortality was recorded. RESULTS: Majority (92[87%]) of the 106 patients included were males, had alcohol (76[72%]) as the etiology of cirrhosis, and alcoholic hepatitis (58[55%]) as the acute precipitating event. Overall, 51(48%) patients died in-hospital. In-hospital mortality in patients with SOFC of 0 (n = 9), 1 (n = 39), 2 (n = 24), 3 (n = 24), 4 (n = 7), and 5 (n = 3) was 0%, 26%, 58%, 71%, 100%, and 100% respectively (P < 0.001), whereas it was 10%, 30%, 58%, and 79% in patients with no-ACLF (n = 21), grades 1 (n = 27), 2 (n = 24), and 3 ACLF (n = 34) respectively (P < 0.001). Patients with no-ACLF (n = 21) had higher mortality than SOFC 0 as they included 9 patients with SOFC 0 (0% mortality) and 12 patients with SOFC 1 (17% mortality). Mortality was similar between 12 no-ACLF and 27 grade 1 ACLF patients (P = 0.462) that comprised SOFC 1. CONCLUSION: SOFC is a simpler and better method than the CANONIC grading system for predicting the in-hospital mortality in patients with ACLF defined as per APASL criteria. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/25251968/Simple_organ_failure_count_versus_CANONIC_grading_system_for_predicting_mortality_in_acute_on_chronic_liver_failure_ L2 - https://doi.org/10.1111/jgh.12778 DB - PRIME DP - Unbound Medicine ER -