HBV-ACLF MELD (HAM) Model of Luo et al for HBV-Related Acute-on-Chronic Liver Failure (ACLF)

Patient selection: HBV-related ACLF

Outcome: 3-month mortality

Parameters:

(1) MELD score

(2) degree of hepatic encephalopathy (HE) using West Haven criteria (Ferenci et al); presumed to be 0 (none) to 4 (coma)

(3) serum AFP in ng/mL

(4) WBC count in 10^9/L

(5) age in years

R =

= (0.174 * (MELD)) + (1.106 * (points for HE)) - (0.003 * (AFP)) + (0.237 * (coefficient for WBC)) + (0.103 * (age)) - 11.388

Interpretation:

• An R >= -1.191 was used as the optimal cut-off with 92% sensitivity and 79% specificity.

Since this is a logistic regression model:

probability of 3 month mortality =

= 1 / (1+ EXP((-1) * R))

Performance:

• The area under the ROC curve was 0.87-0.89.