Child-Pugh, MELD, and ALBI scores for predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure

Expert Rev Gastroenterol Hepatol. 2016 Aug;10(8):971-80. doi: 10.1080/17474124.2016.1177788. Epub 2016 Apr 25.

Abstract

Objectives: Our study aimed to evaluate the discriminative abilities of Child-Pugh, model for end-stage liver disease (MELD), and albumin-bilirubin (ALBI) scores in predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure (ACLF).

Methods: Cirrhotic patients with ACLF admitted between 2010 January and 2014 June were retrospectively reviewed. Areas under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs) were calculated.

Results: One hundred patients were eligible for the Asia-Pacific Association for the Study of the Liver (APASL) criteria. AUROCs of Child-Pugh, MELD, and ALBI scores in predicting the in-hospital mortality was 0.63 (95%CI: 0.52-0.72, P = 0.05), 0.75 (95%CI: 0.65-0.83, P < 0.0001), and 0.53 (95%CI: 0.42-0.63, P = 0.69), respectively. Eighty-eight patients were eligible for the EASL/AASLD criteria. AUROCs of Child-Pugh, MELD, and ALBI scores in predicting the in-hospital mortality were 0.59 (95%CI: 0.48-0.69, P = 0.14), 0.57 (95%CI: 0.46-0.68, P = 0.26), and 0.57 (95%CI: 0.46-0.67, P = 0.29), respectively. There was no significant difference among them.

Conclusion: Child-Pugh, MELD, and ALBI scores might be ineffective in predicting the in-hospital mortality of cirrhosis with ACLF.

Keywords: ACLF; ALBI; cirrhosis; mortality; prognosis.

Publication types

  • Comparative Study

MeSH terms

  • Acute-On-Chronic Liver Failure / blood
  • Acute-On-Chronic Liver Failure / diagnosis
  • Acute-On-Chronic Liver Failure / etiology
  • Acute-On-Chronic Liver Failure / mortality*
  • Adult
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Biomarkers / blood
  • End Stage Liver Disease / blood
  • End Stage Liver Disease / diagnosis
  • End Stage Liver Disease / etiology
  • End Stage Liver Disease / mortality*
  • Female
  • Health Status
  • Health Status Indicators*
  • Hospital Mortality*
  • Humans
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / mortality*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers