Bajaj et al reported risk factors associated with 30-day mortality for a patient with infection-related acute-on-chronic liver failure (ACLF). These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in the United States and Canada belonging to the North American Consortium for the Study of End-stage Liver Disease (NACSELD).
Patient selection: infection-related acute-on-chronic liver failure
Predictors of 30-day mortality:
(1) number of organ failures in the I-ACLF (from 0 to 4; risk increased when >= 2)
(2) high MELD score on admission
(3) low mean arterial pressure (shock when < 60 mm Hg or a decrease by 40 mm Hg from baseline)
(4) high admission white blood cell count
(5) hypoalbuminemia
(6) second infections (an infection diagnosed after a separate first infection had been documented)
where:
• The admission serum albumin in the study 2.7 +/- 1.4.
• The admission WBC in the study was 8.334 +/- 6,897 per µL
• The admission mean arterial pressure was 82.3 +/- 18.2.
• The admission MELD was 19.9 +/- 8.3
