title: Different models in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure.
abstract: OBJECTIVE
  Effective assessing the prognosis of patients with end-stage liver disease is always challenging. This study aimed to investigate the accuracy of different models in predicting short-term prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).
  
  
  METHODS
  We retrospectively evaluated survival of a cohort of patients with at least 3-month follow up. The receiver-operating-characteristic curves (ROC) were drawn for Child-Turcotte-Pugh (CTP) classification, King's College Hospital (KCH) criteria, model for end-stage liver disease (MELD), MELD combined with serum sodium (Na) concentration (MELDNa), integrated MELD (iMELD) and logistic regression model (LRM).
  
  
  RESULTS
  Of the 273 eligible patients, 152 patients (55.7%) died within 3-month follow up. In cirrhotic patients (n = 101), the AUCs of LRM (0.851), MELDNa (0.849), iMELD (0.845) and MELD (0.840) were all significantly higher than those of KCH criteria (0.642) and CTP (0.625) (all p < 0.05), while the differences among LRM, MELD, MELDNa and iMELD were not significant, and the most predictive cutoff value was 0.5176 for LRM, 30 for MELDNa, 47.87 for iMELD and 29 for MELD, respectively. In non-cirrhotic patients (n = 172), the AUC of LRM (0.897) was significantly higher than that of MELDNa (0.776), iMELD (0.768), MELD (0.758), KCH criteria (0.647) and CTP (0.629), respectively (all p < 0.05), and the most predictive cutoff value for LRM was -0.3264.
  
  
  CONCLUSIONS
  LRM, MELD, MELDNa and iMELD are with similar accuracy in predicting the shortterm prognosis of HBV-ACLF patients with liver cirrhosis, while LRM is superior to MELD, MELDNa and iMELD in predicting the short-term prognosis of HBV-ACLF patients without liver cirrhosis.
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Yang
authors.forename: En-Qiang
authors.initials: EQ
authors.lastname: Chen
authors.forename: Hong-Xia
authors.initials: HX
authors.lastname: Bi
authors.forename: Lang
authors.initials: L
authors.lastname: Bai
authors.forename: Xue-Bin
authors.initials: XB
authors.lastname: Chen
authors.forename: Ping
authors.initials: P
authors.lastname: Feng
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications; D006515:Hepatitis B virus; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000821:virology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D055815:Young Adult
chemical_list: D012964:Sodium