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A Novel prognostic scoring system to predict 3-month mortality risk in patients with acute-on-chronic liver failure in hepatitis B: a retrospective cohort study

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Abstract

Purpose

The present study was done to establish an objective, sensitive prognostic scoring system and to determine the applicability of this model in predicting the 3-month mortality of patients with acute-on-chronic liver failure in hepatitis B (ACLFB).

Methods

We developed a novel prognostic scoring system, calculated from six clinical indices including serum total bilirubin, prothrombin activity, serum creatinine, hepatic encephalopathy, infections, and the depth of ascites from 499 patients with ACLFB. Differences in the sensitivity, specificity, and practicality of a Novel prognostic scoring system and the model of end-stage liver disease (MELD) were analyzed.

Results

The areas under the receiver operating characteristic curve (ROC) for the Novel scoring systems and MELD scoring systems were 0.967 (95% CI, 0.956–0.977) and 0.900 (95% CI, 0.878–0.922), respectively. The analysis of the ROC curve indicated that the Novel scoring systems were an exact, pertinent, and objective prognostic model with greater accuracy than the MELD. In the Novel scoring systems, the survival rate of these patients whose scores ranged from 2 to 6 was 98.80%, while for those whose scores point at 7 and 15, the mortality rates were 8.70% (2/23) and 95.45% (21/22), respectively, and the mortality rate of these patients whose scores were 16 and above was 100.00%. However, in the MELD prognostic scoring systems, there were no score ranges with 100.00% survival rate.

Conclusions

We developed an objective, pertinent, and sensitive prognostic scoring system that predicted the 3-month mortality of patients with ACLFB with greater accuracy than the MELD.

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Acknowledgements

We also thank all HBV-infected individuals in this study. This manuscript was edited and proofread by Medjaden Bioscience Limited. This work was supported by grants from the Natural Science Fund of Guangdong province (No.10451008901004818), the National Natural Science Foundation of China (No. 30971356), and the National Grand Program on Key Infectious Disease in the treatment and prevention of infectious diseases of AIDS and viral hepatitis, China (No.2012ZX10002007-002), the Technology Project Fund of Guangdong province, China (No.2008B060600024).

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Authors and Affiliations

  1. Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Tianhe Road 600# Gangding, Guangzhou City, 510630, People’s Republic of China

    Yu-Bao Zheng, Shi-Bin Xie, Dong-Ying Xie, Liang Peng, Zi-Ying Lei, Hong Deng, Bin-Liang Lin, Chao-Shuang Lin, Zhi-Xin Zhao, Wei-Min Ke & Zhi-Liang Gao

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  1. Yu-Bao Zheng
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  2. Shi-Bin Xie
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Correspondence to Yu-Bao Zheng.

Additional information

W.-M. Ke and Z.-L. Gao contributed equally to this article.

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Zheng, YB., Xie, SB., Xie, DY. et al. A Novel prognostic scoring system to predict 3-month mortality risk in patients with acute-on-chronic liver failure in hepatitis B: a retrospective cohort study. Hepatol Int 6, 727–734 (2012). https://doi.org/10.1007/s12072-011-9335-2

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