Validation of Clif-C-Aclf Score for Alcoholic Liver Cirrhosis
Slyvka, N.; Virstyuk, N.; Abdelrahman, F.
Georgian Medical News 278: 98-103
2018
ISSN/ISBN: 1512-0112 PMID: 29905553 Document Number: 695316
The concept of acute-on-chronic liver failure (ACLF) covers acute deterioration of the liver function in patients with alcoholic cirrhosis (ALC) caused by secondary or extra-hepatic provoking factors (PF) leading to dysfunction of target organs. CLIF-C-ACLF score refers to the number of decompensated organs/systems and is recommended for predicting outcome in patients with ALC. Objective - to compare the diagnostic value of the Child-Pugh score and the CLIF-C-ACLF score for predicting short-term mortality in patients with ALC. The clinical data of 150 patients with ALC were retrospectively analyzed. Enrolled patients were divided into 2 groups according to the presence / absence of PF 3 months before the death: I group (n = 83) - without PF (CLF), group II (n= 67) - with PF (ACLF). To assess the severity of ALC we used the Child-Pugh score and the CLIF-C-ACLF score. Infectious complications were considered as PF. The sensitivity of the STMP by Child-Pugh score in group 1 was 100% (95% CI 58.9-100), specificity was 38.9% (95% CI 30.9-47.4). The sensitivity for the CLIF-C-ACLF score was 100% (95% CI 58.9-100), specificity-93.75% (95% CI 88.5-97.1).A. The sensitivity of STMP by Child-Pugh score in group II was 100% (95% CI 54.1-100), specificity was 29.5% (95% CI -42.6 to 18.5). The sensitivity of STMP by CLIF-C-ACLF in score II was 100% (95% CI 58.9-100), specificity was 88.5% (95% CI 77.8-95.2). The CLIF-C-ACLF corresponded to the model of excellent quality in groups I (0.99) and II (0.97) and was higher than the Child-Pugh score in both groups (p = 0.012 and p = 0.015 respectively). The diagnostic value of the CLIF-C-ACLF score for predicting short-term mortality in patients with ALC is higher than Child-Pugh, especially for acute decompensation of ALC caused by precipitating factors.