1. THU-053-Usefulness of lactate-free Asian Pacific Association for The Study of Liver acute-on-chronic liver failure research consortium ACLF score for predicting short-term mortality in patient with alcoholic liver disease
- Author
-
Do Seon Song, Tae Yeob Kim, Hee Yeon Kim, Eileen L Yoon, Dong Joon Kim, Ji-Dong Jia, Ashok Choudhury, Mamun Al-Mahtab, Harshad Devarbhavi, Zhongping Duan, Yu Chen, CE Eapen, Ashish Goel, Qin Ning, Ke Ma, Yogesh Chawla, Radha Krishan Dhiman, Ajay Duseja, Sunil Taneja, Saeed Sadiq Hamid, Amna Subhan, Wasim Jafri, Soek-Siam Tan, Hasmik Ghazinian, Deepak Amarapurkar, Sombat Treeprasertsuk, Guan Huei Lee, Seng Gee Lim, Jinhua Hu Hu, Laurentius A. Lesmana, Rinaldi Lesmana, Akash Shukla, Samir Shah, Chetan Kalal, Manoj Sahoo, Zaigham Abbas, Joyes s, Gian Carpio, Md. Fazal Karim, George Lau, Nagaraja Rao Padaki, Diana Payawal, A. Kadir Dokmeci, Man-Fung Yuen, V GM, Osamu Yokosuka, Ananta Shrestha, Priyanka Jain, Irene Paulson, and Shiv Kumar Sarin
- Subjects
Alcoholic liver disease ,medicine.medical_specialty ,Scoring system ,Hepatology ,Receiver operating characteristic ,business.industry ,Short term mortality ,medicine.disease ,Liver disease ,Internal medicine ,Cohort ,medicine ,Acute on chronic liver failure ,In patient ,business - Abstract
Aims: Asian Pacific Association for the Study of Liver (APASL) acute-on-chronic liver failure (ACLF) Research Consortium (AARC) proposed new prognostic scoring system of ACLF in cluding lactate. However, lactate is not routinely checked in clinical practice of patient with ACLF in Korea. Therefore, we aimed to investigate the predictive accuracy of lactate-free AARC-ACLF score for predicting short-term mortality in patients with alcoholic liver disease. Methods: A total of 749 ALD patients who had liver failure (bilirubin≥5mg/dL and INR≥1.5) in AARC database were in vestigated. Diagnostic performances for short-term mortality were compared according to the area under receiver operating characteristic (AUROC) curve. Predictive accuracy of lactate-free AARC-ACLF score were compared with other prognostic scores in 143 ALD patients with liver failure and 60 ALD patients with ACLF according to AARC definition in Korean ACLF cohort. Results: Among 749 patients, 30-day and 90-day mortality were 40.3% and 51.5%. There were no significant differences in AUROC for predicting 30-day and 90-day mortality between AARC-ACLF score and lactate-free AARC-ACLF score (30-day mortality: 0.752 vs. 0.751, P=0.918, 90-day mortality: 0.728 vs. 0.736, P=0.346). In Korean ACLF cohort, the AUROCs of lactate-free AARC-ACLF score for predicting 28-day and 90- day mortality were 0.861 and 0.846 in ALD with liver failure, and 0.884 and 0.874 in ALD patients with ACLF according to AARC definition, respectively. In Korean ALD patients with liver failure and ACLF according to AARC definition, diagnostic per formance of lactate-free AARC-ACLF score for predicting 28- day and 90-day mortality was comparable to those of Model for End-stage Liver Disease (MELD), MELD-Na, Chronic Liver Failure-Sequential Organ Failure Assessment score. Conclusions: Lactate-free AARC-ACLF score is as excellent as AARC-ACLF score in predicting short-term mortality in ALD patients with liver failure of AARC database and Korean ACLF cohort.
- Published
- 2019
- Full Text
- View/download PDF