Predictive value of the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score in the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure
10.1097/CM9.0000000000000298
- Author:
Jing-Jing TONG
1
;
Wei ZHAO
2
;
Xiu-Ying MU
3
;
Xiang XU
1
;
Hai-Bin SU
1
;
Xiao-Yan LIU
1
;
Jing CHEN
1
,
4
;
Xing-Ran ZHAI
3
;
Yu WANG
4
;
Jin-Hua HU
1
,
3
,
4
Author Information
1. Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
2. Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing 100029, China
3. Peking University 302 Clinical Medical School, Beijing 100039, China
4. Medical School of Chinese PLA, Beijing 100853, China
- Publication Type:Journal Article
- Keywords:
Hepatitis B virus-related acute-on-chronic liver failure;
COSSH-ACLF score;
Predictive value;
Prognosis
- From:
Chinese Medical Journal
2019;132(13):1541-1549
- CountryChina
- Language:English
-
Abstract:
Background:As a large, prospective, multicenter study-based prognostic score for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score (COSSH-ACLFs), has been approved by some foreign scholars; however, its predictive value needs to be verified. This study investigated the predictive value of COSSH-ACLFs for short-term prognosis in Chinese patients with HBV-ACLF.
Methods:This retrospective cohort study included 751 patients with HBV-ACLF admitted to the Fifth Medical Center of Chinese PLA General Hospital between January 2011 and December 2014. Spearman method was used to assess the correlation of COSSHACLFs with classical scores. Different COX multivariate regression models were used to confirm the relationship between COSSHACLFs and short-term prognosis in patients with HBV-ACLF, and stratified analysis was used to further verify the stability of this relationship. We compared the predictive powers of COSSH-ACLFs and other classical scores using area under the receiver operating characteristic curve (AUROC) and Z-test.
Results:A total of 975 patients with HBV-ACLF were screened, and 751 were analyzed (623 male and 128 female). COSSH-ACLFs was the highest in patients with end-stage ACLF, followed by those with middle- and early-stage ACLF (H = 211.8, P < 0.001). In the fully adjusted model, COX multivariate regression analysis revealed that COSSH-ACLFs (as a continuous variable) was independently and positively correlated with mortality risk in patients with HBV-ACLF at 28 days (hazard ratio [HR]: 1.37 [1.22, 1.53], P < 0.001) and 90 days (HR: 1.43 [1.29, 1.58], P < 0.001). The same trend could be observed in the crude model and minimally adjusted model. The AUROCs of COSSH-ACLFs for 28-day and 90-day prognoses in patients with HBV-ACLF were 0.807 and 0.792, respectively, indicating a stronger predictive accuracy than those of classic models.
Conclusions:COSSH-ACLFs, with a superior predictive accuracy compared with other classical scores, can strongly predict shortterm prognosis in Chinese patients with HBV-ACLF.
