title: Scoring systems for 6-month mortality in critically ill cirrhotic patients: a prospective analysis of chronic liver failure - sequential organ failure assessment score (CLIF-SOFA).
abstract: BACKGROUND
  Cirrhotic patients admitted to intensive care units (ICUs) have high mortality rates. The Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score, a modified Sequential Organ Failure Assessment (SOFA) score, is a newly developed scoring system exclusively for patients with end-stage liver disease.
  
  
  OBJECTIVE
  To externally validate the efficacy of the CLIF-SOFA score and evaluate other scoring systems for 6-month mortality in critically ill cirrhotic patients.
  
  
  METHODS
  This study prospectively recorded and analysed the data for 30 demographical parameters and some clinical characteristic variables on day 1 of 250 cirrhotic patients admitted to a 10-bed specialised hepatogastroenterology ICU in a 2000-bed tertiary care referral hospital during the period from September 2010 to August 2013.
  
  
  RESULTS
  The overall in-hospital and 6-month mortality rate were 58.8% (147/250) and 78.0% (195/250), respectively. Liver diseases were mostly attributed to hepatitis B virus infection (32%). Multiple Cox logistic regression hazard analysis revealed that Glasgow coma scale, both the CLIF-SOFA and Acute Physiology and Chronic Health Evaluation III (ACPACHE III) scores determined on the first day of ICU admission were independent predictors of 6-month mortality. Analysis of the area under the receiver operating characteristic curve revealed that the CLIF-SOFA score had the best discriminatory power (0.900 ± 0.020). Moreover, the cumulative 6-month survival rates differed significantly for patients with a CLIF-SOFA score ≤11 and those with a CLIF-SOFA score >11 on the ICU admission day.
  
  
  CONCLUSIONS
  Both CLIF-SOFA and APACHE III scores are excellent prognosis evaluation tools for critically ill cirrhotic patients.
authors.affiliation: Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: H-C
authors.initials: HC
authors.lastname: Pan
authors.forename: C-C
authors.initials: CC
authors.lastname: Jenq
authors.forename: M-H
authors.initials: MH
authors.lastname: Tsai
authors.forename: P-C
authors.initials: PC
authors.lastname: Fan
authors.forename: C-H
authors.initials: CH
authors.lastname: Chang
authors.forename: M-Y
authors.initials: MY
authors.lastname: Chang
authors.forename: Y-C
authors.initials: YC
authors.lastname: Tian
authors.forename: C-C
authors.initials: CC
authors.lastname: Hung
authors.forename: J-T
authors.initials: JT
authors.lastname: Fang
authors.forename: C-W
authors.initials: CW
authors.lastname: Yang
authors.forename: Y-C
authors.initials: YC
authors.lastname: Chen
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends