title: Comparison of the prognostic value of Chronic Liver Failure Consortium scores and traditional models for predicting mortality in patients with cirrhosis.
abstract: OBJECTIVE
  Recently, the European Association for the Study of the Liver - Chronic Liver Failure (CLIF) Consortium defined two new prognostic scores, according to the presence or absence of acute-on-chronic liver failure (ACLF): the CLIF Consortium ACLF score (CLIF-C ACLFs) and the CLIF-C Acute Decompensation score (CLIF-C ADs). We sought to compare their accuracy in predicting 30- and 90-day mortality with some of the existing models: Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), MELD-Na, integrated MELD (iMELD), MELD to serum sodium ratio index (MESO), Refit MELD and Refit MELD-Na.
  
  
  METHODS
  Retrospective cohort study that evaluated all admissions due to decompensated cirrhosis in 2 centers between 2011 and 2014. At admission each score was assessed, and the discrimination ability was compared by measuring the area under the ROC curve (AUROC).
  
  
  RESULTS
  A total of 779 hospitalizations were evaluated. Two hundred and twenty-two patients met criteria for ACLF (25.9%). The 30- and 90-day mortality were respectively 17.7 and 37.3%. CLIF-C ACLFs presented an AUROC for predicting 30- and 90-day mortality of 0.684 (95% CI: 0.599-0.770) and 0.666 (95% CI: 0.588-0.744) respectively. No statistically significant differences were found when compared to traditional models. For patients without ACLF, CLIF-C ADs had an AUROC for predicting 30- and 90-day mortality of 0.689 (95% CI: 0.614-0.763) and 0.672 (95% CI: 0.624-0.720) respectively. When compared to other scores, it was only statistically superior to MELD for predicting 30-day mortality (p=0.0296).
  
  
  CONCLUSIONS
  The new CLIF-C scores were not statistically superior to the traditional models, with the exception of CLIF-C ADs for predicting 30-day mortality.
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal. Electronic address: sergiogiao@hotmail.com.
authors.forename: Artur Gião
authors.initials: AG
authors.lastname: Antunes
authors.affiliation: Gastroenterology Department, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Teixeira
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal.
authors.forename: Ana Margarida
authors.initials: AM
authors.lastname: Vaz
authors.affiliation: Gastroenterology Department, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Martins
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Queirós
authors.affiliation: Gastroenterology Department, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Alves
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Velasco
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal.
authors.forename: Bruno
authors.initials: B
authors.lastname: Peixe
authors.affiliation: Gastroenterology Department, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Oliveira
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal.
authors.forename: Horácio
authors.initials: H
authors.lastname: Guerreiro
mesh_terms: D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D012189:Retrospective Studies
keywords: Cirrosis hepática; Liver cirrhosis; Mortalidad; Mortality; Prognosis; Pronóstico; Sobrevida; Survival