The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure

Jalan, Rajiv; Pavesi, Marco; Saliba, Faouzi; Amorós, Alex; Fernandez, Javier; Holland-Fischer, Peter; Sawhney, Rohit; Mookerjee, Rajeshwar; Caraceni, Paolo; Moreau, Richard; Ginès, Pere; Durand, Francois; Angeli, Paolo; Alessandria, Carlo; Laleman, Wim; Trebicka, Jonel; Samuel, Didier; Zeuzem, Stefan; Gustot, Thierry; Gerbes, Alexander L; ... (2015). The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure. Journal of hepatology, 62(4), pp. 831-840. Elsevier 10.1016/j.jhep.2014.11.012

[img] Text
The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure..pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (967kB) | Request a copy

BACKGROUND & AIMS Cirrhotic patients with acute decompensation frequently develop acute-on-chronic liver failure (ACLF), which is associated with high mortality rates. Recently, a specific score for these patients has been developed using the CANONIC study database. The aims of this study were to develop and validate the CLIF-C AD score, a specific prognostic score for hospitalised cirrhotic patients with acute decompensation (AD), but without ACLF, and to compare this with the Child-Pugh, MELD, and MELD-Na scores. METHODS The derivation set included 1016 CANONIC study patients without ACLF. Proportional hazards models considering liver transplantation as a competing risk were used to identify score parameters. Estimated coefficients were used as relative weights to compute the CLIF-C ADs. External validation was performed in 225 cirrhotic AD patients. CLIF-C ADs was also tested for sequential use. RESULTS Age, serum sodium, white-cell count, creatinine and INR were selected as the best predictors of mortality. The C-index for prediction of mortality was better for CLIF-C ADs compared with Child-Pugh, MELD, and MELD-Nas at predicting 3- and 12-month mortality in the derivation, internal validation and the external dataset. CLIF-C ADs improved in its ability to predict 3-month mortality using data from days 2, 3-7, and 8-15 (C-index: 0.72, 0.75, and 0.77 respectively). CONCLUSIONS The new CLIF-C ADs is more accurate than other liver scores in predicting prognosis in hospitalised cirrhotic patients without ACLF. CLIF-C ADs therefore may be used to identify a high-risk cohort for intensive management and a low-risk group that may be discharged early.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

De Gottardi, Andrea

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0168-8278

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

31 Mar 2016 15:02

Last Modified:

31 Mar 2016 15:02

Publisher DOI:

10.1016/j.jhep.2014.11.012

PubMed ID:

25463539

Uncontrolled Keywords:

Acute-on-chronic liver failure; Chronic liver failure; Hepatic encephalopathy

BORIS DOI:

10.7892/boris.77707

URI:

https://boris.unibe.ch/id/eprint/77707

Actions (login required)

Edit item Edit item
Provide Feedback