title: Assessment of scoring systems for acute-on-chronic liver failure at predicting short-term mortality in patients with alcoholic hepatitis.
abstract: OBJECTIVE
  To assess the performance of proposed scores specific for acute-on-chronic liver failure in predicting short-term mortality among patients with alcoholic hepatitis.
  
  
  METHODS
  We retrospectively collected data from 264 patients with clinically diagnosed alcoholic hepatitis from January to December 2013 at 21 academic hospitals in Korea. The performance for predicting short-term mortality was calculated for Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA), CLIF Consortium Organ Failure score (CLIF-C OFs), Maddrey's discriminant function (DF), age, bilirubin, international normalized ratio and creatinine score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), model for end-stage liver disease (MELD), and MELD-Na.
  
  
  RESULTS
  Of 264 patients, 32 (12%) patients died within 28 d. The area under receiver operating characteristic curve of CLIF-SOFA, CLIF-C OFs, DF, ABIC, GAHS, MELD, and MELD-Na was 0.86 (0.81-0.90), 0.89 (0.84-0.92), 0.79 (0.74-0.84), 0.78 (0.72-0.83), 0.81 (0.76-0.86), 0.83 (0.78-0.88), and 0.83 (0.78-0.88), respectively, for 28-d mortality. The performance of CLIF-SOFA had no statistically significant differences for 28-d mortality. The performance of CLIF-C OFs was superior to that of DF, ABIC, and GAHS, while comparable to that of MELD and MELD-Na in predicting 28-d mortality. A CLIF-SOFA score of 8 had 78.1% sensitivity and 79.7% specificity, and CLIF-C OFs of 10 had 68.8% sensitivity and 91.4% specificity for predicting 28-d mortality.
  
  
  CONCLUSIONS
  CLIF-SOFA and CLIF-C OF scores performed well, with comparable predictive ability for short-term mortality compared to the commonly used scoring systems in patients with alcoholic hepatitis.
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Hee Yeon
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Do Seon
authors.initials: DS
authors.lastname: Song
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Sinn
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Eileen L
authors.initials: EL
authors.lastname: Yoon
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Young Kul
authors.initials: YK
authors.lastname: Jung
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Chang Hyeong
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Tae Hun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Jeong Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Byung Seok
authors.initials: BS
authors.lastname: Lee
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Yang
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Heon Ju
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Park
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Choi
authors.affiliation: Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D000328:Adult; D019540:Area Under Curve; D003661:Decision Support Techniques; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006519:Hepatitis, Alcoholic / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: Acute-on-chronic liver failure; Alcoholic hepatitis; Mortality; Prognosis; Scoring system