Establishment of prognostic scoring models for different etiologies of acute decompensation in hospitalized patients with cirrhosis

Abstract

Objective Acute decompensation (AD) in liver cirrhosis has high mortality. We assessed prognostic scoring models and established prediction models for different etiologies of AD. Methods This retrospective analysis included 732 patients hospitalized with acute decompensated cirrhosis without acute-on-chronic liver failure. We performed logistic regression analysis of risk factors for mortality associated with different etiologies, to establish predictive models. Results Patients with different etiologies, scored using different scoring systems and various impact factors, exhibited differences with respect to mortality. MELD, CLIF-C-AD, MELD-Na, and AARC-ACLF scores exhibited adequate predictive ability for mortality. Area under the receiver operating characteristic curve for 28-day mortality for MELD, CLIF-C-AD, MELD-Na, AARC-ACLF, and the newly developed AD scores was 0.663, 0.673, 0.657, 0.662, and 0.773, respectively, in the hepatitis B virus group (HBV-AD score =−5.51 + 0.07*WBC count (10 9 /L) +0.7*AD sum+0.4*AARC-ACLF score); 0.731, 0.737, 0.735, 0.689, and 0.778, respectively, in the alcoholic liver disease group (ALD-AD score =−4.55 +0.08* WBC count (10 9 /L) +1.34* AD sum); and 0.765, 0.767, 0.814, 0.720, and 0.814, respectively, in the Others group (OTHERS-AD score =−2.14 + 1.24*MELD-Na score +4.49*AD sum). Conclusions The newly developed scoring models for short-term mortality were superior to the other scoring systems in predicting prognosis of acute decompensated cirrhosis in hospitalized patients.