用于预测 APASL-ACLF 患者死亡率的新评分 "NOD-ACLF "与其他既定预后评分的比较：印度北部一家三级医疗中心的队列研究

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Clinical and Experimental Hepatology Pub Date : 2024-02-23 DOI:10.1016/j.jceh.2024.101366

Ajay K. Patwa , Khushboo Yadav , Virendra Atam , Kauser Usman , Satyendra K. Sonkar , Shyam C. Chaudhary , Vivek Kumar , Kamal K. Sawlani , Kamlesh K. Gupta , Munna L. Patel , Dandu H. Reddy , Harish Gupta , Medhavi Gautam , Satish Kumar , Amit Kumar , Ambuj Yadav , Deepak Bhagchandani , Mahak Lamba , Abhishek Singh , Ajay K. Mishra

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引用次数: 0

摘要

背景常用的急性慢性肝衰竭（ACLF）预后评分计算复杂。在这项前瞻性队列研究中，纳入了根据亚太肝脏研究协会（APASL）定义确诊的急性肝功能衰竭患者。计算严重程度评分。分析了预后因素。结果在80例急性慢性肝衰竭患者中，男性74例（92.5%），女性6例（7.5%）。平均年龄为 41.0±10.7（18-70）岁。急性损伤情况为：酒精 48 例（60%）、败血症 30 例（37.5%）、静脉曲张出血 22 例（27.5%）、病毒 8 例（10%）和药物 3 例（3.8%）。慢性疾病的特征是酒精 61 例（76.3%）、病毒 20 例（25%）、自身免疫 3 例（3.8%）和非酒精性脂肪性肝炎 2 例（2.5%）。38人（47.5%）出院，42人（52.5%）死亡。器官功能障碍的平均数量（NOD-ACLF评分）为->4.5，简单器官衰竭计数（SOFC）评分为>2.5，APASL ACLF研究联盟评分为>11.5，终末期肝病乳酸模型（MELD-LA）评分为>21.5，心血管和呼吸功能障碍的存在与死亡率显著相关。结论 NOD-ACLF 评分易于床旁计算，是 ACLF 患者死亡率的良好预测指标，其表现与其他评分相似或更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Comparison of a Novel Score “NOD−ACLF” to Other Established Prognostic Scores for Prediction of Mortality in APASL−ACLF Patients: A Cohort Study from a Tertiary Care Center of North India

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Comparison of a Novel Score “NOD−ACLF” to Other Established Prognostic Scores for Prediction of Mortality in APASL−ACLF Patients: A Cohort Study from a Tertiary Care Center of North India

Background

Commonly used prognostic scores for acute on-chronic liver failure (ACLF) have complex calculations. We tried to compare the simple counting of numbers and types of organ dysfunction to these scores, to predict mortality in ACLF patients.

Methods

In this prospective cohort study, ACLF patients diagnosed on the basis of Asia Pacific Association for Study of the Liver (APASL) definition were included. Severity scores were calculated. Prognostic factors for outcome were analysed. A new score, the Number of Organ Dysfunctions in Acute-on-Chronic Liver Failure (NOD-ACLF) score was developed.

Results

Among 80 ACLF patients, 74 (92.5%) were male, and 6 were female (7.5%). The mean age was 41.0±10.7 (18–70) years. Profile of acute insult was; alcohol 48 (60%), sepsis 30 (37.5%), variceal bleeding 22 (27.5%), viral 8 (10%), and drug-induced 3 (3.8%). Profiles of chronic insults were alcohol 61 (76.3%), viral 20 (25%), autoimmune 3 (3.8%), and non-alcoholic steatohepatitis 2 (2.5%). Thirty-eight (47.5%) were discharged, and 42 (52.5%) expired. The mean number of organ dysfunction (NOD-ACLF score) was ->4.5, simple organ failure count (SOFC) score was >2.5, APASL ACLF Research Consortium score was >11.5, Model for End-Stage Liver Disease-Lactate (MELD-LA) score was >21.5, and presence of cardiovascular and respiratory dysfunctions were significantly associated with mortality. NOD-ACLF and SOFC scores had the highest area under the receiver operating characteristic to predict mortality among all these.