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Model of Gao et al for Acute-on-Chronic Liver Failure (ACLF) Associated with Hepatitis B Virus (HBV)

Description

Gao et al evaluated patients with acute-on-liver failure (ACLF) associated with hepatitis B viral (HBV) infection. They developed a prognostic model which can help to identify a patient who may benefit from more aggressive management. The authors are from Capital Medical University in Beijing.


Patient selection: chronic HBV

 

Outcome: acute-on-chronic liver failure

 

Parameters:

(1) age in years

(2) serum total bilirubin in µmol/L

(3) percent prothrombin activity

(4) HBV DNA viral load in copies per mL

 

Parameter

Finding

Points

age in years

< 40 years

0

 

>= 40 years

1

serum total bilirubin

< 171 µmol/L

0

 

>= 171 µmol/L

1

percent prothrombin activity

> 60%

0

 

50.1 to 60%

2

 

40 to 50%

3

HBV DNA viral load

LOG10 <= 7.0

0

 

LOG10 > 7.0

2

 

where:

• A percent prothrombin activity less than 40% was not shown.

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the greater the risk of ACLF.

• A score >= 4 was considered high risk for ACLF. Patients in the high risk group had a mortality rate of about 10%.

• A score from 0 to 3 was considered low risk.

 

Total Score

Percent ACLF

0 or 1

0%

2

1.6%

3

6%

4

23%

5

32%

6 or 7

67%

after Figure 2

 

Performance:

• The area under the ROC curve was 0.86 in the derivation cohort.


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