Liang Chen1,2, Jun Zheng1,2, Jianye Cai1,2, Yusheng Jie2,3, Yingcai Zhang1,2, Hui Li1,2, Tongyu Lu1,2, Liying He4, Cuicui Xiao2,5, Kaining Zeng1,2, Hongyuan Fu1,2, Haibo Li1,2, Bin Ouyang6, Guihua Chen1,2, Jia Yao7,8, Jiao Gong9, Yang Yang1,2. 1. Department of Hepatic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangdong, China. 2. Guangdong Key Laboratory of Liver Disease Research, Key Laboratory of Liver disease biotherapy and Translational Medicine of Guangdong Higher Education Institute, The Third Affiliated Hospital, Sun Yat-sen University, Guangdong, China. 3. Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-sen Universit, Guangdong, China. 4. Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangdong, China. 5. Biological Therapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangdong, China. 6. Department of Andrology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangdong, China. 7. Department of Hepatic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangdong, Chinagodzeus-viii@163.com. 8. Guangdong Key Laboratory of Liver Disease Research, Key Laboratory of Liver disease biotherapy and Translational Medicine of Guangdong Higher Education Institute, The Third Affiliated Hospital, Sun Yat-sen University, Guangdong, Chinagodzeus-viii@163.com. 9. Department of Laboratory Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangdong, Guangdong, China.
Abstract
BACKGROUND/AIMS: The age-bilirubin-international normalized ratio-creatinine (ABIC) score, which is a predictive model commonly used for alcoholic hepatitis, has not yet been studied in acute-on-chronic hepatitis B liver failure (HBV-ACLF). We aimed to investigate the predictive value of the ABIC score in patients with HBV-ACLF. METHODS: This retrospective study involved 398 patients diagnosed with HBV-ACLF, who were divided into a training cohort of 305 patients and a validation cohort of 93 patients. Univariate and multivariate Cox regression models were used to determine risk factors for mortality. Area under the receiver operating characteristic curve (AUC) was calculated to estimate and compare the predictive values of different prognostic scores. RESULTS: The ABIC score was significantly higher in the death group of the training cohort than in its survival group. Independent risk factors for mortality identified by multivariate Cox analysis included blood urea nitrogen, ABIC score, and Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) score. For predicting 1- and 3-month mortality, AUC was higher for the ABIC score than for the Model for End-stage Liver Diseases (MELD) score (0.732 vs. 0.653, P < 0.05, 0.695 vs. 0.619, P < 0.05, respectively), CLIF-C OF score (0.693, P=0.353, 0.656, P=0.341, respectively), and Child-Pugh score (0.675, P=0.189, 0.656, P=0.300, Respectively). Patients with ABIC score > 9.44 had reduced 1- and 3-month survival rates. CONCLUSION: ABIC score is superior to MELD score in predicting short-term survival in HBV-ACLF patients. ABIC score > 9.44 predicts high short-term mortality risk in HBV-ACLF patients.
BACKGROUND/AIMS: The age-bilirubin-international normalized ratio-creatinine (ABIC) score, which is a predictive model commonly used for alcoholic hepatitis, has not yet been studied in acute-on-chronic hepatitis B liver failure (HBV-ACLF). We aimed to investigate the predictive value of the ABIC score in patients with HBV-ACLF. METHODS: This retrospective study involved 398 patients diagnosed with HBV-ACLF, who were divided into a training cohort of 305 patients and a validation cohort of 93 patients. Univariate and multivariate Cox regression models were used to determine risk factors for mortality. Area under the receiver operating characteristic curve (AUC) was calculated to estimate and compare the predictive values of different prognostic scores. RESULTS: The ABIC score was significantly higher in the death group of the training cohort than in its survival group. Independent risk factors for mortality identified by multivariate Cox analysis included blood ureanitrogen, ABIC score, and Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) score. For predicting 1- and 3-month mortality, AUC was higher for the ABIC score than for the Model for End-stage Liver Diseases (MELD) score (0.732 vs. 0.653, P < 0.05, 0.695 vs. 0.619, P < 0.05, respectively), CLIF-C OF score (0.693, P=0.353, 0.656, P=0.341, respectively), and Child-Pugh score (0.675, P=0.189, 0.656, P=0.300, Respectively). Patients with ABIC score > 9.44 had reduced 1- and 3-month survival rates. CONCLUSION: ABIC score is superior to MELD score in predicting short-term survival in HBV-ACLF patients. ABIC score > 9.44 predicts high short-term mortality risk in HBV-ACLF patients.