• Dakai Gan, Yuyu Zeng, Kaige Zhang, Yang He, Jiao Wan, Xiaoqing Zhang, Zhen Zhang, Longchuan Zhu, Tao Long, Nengwen Xie, Bo Zou, Xuezhen Zhang, Yunfeng Xiong, Guoliang Feng, Daya Luo, and Molong Xiong.
• Infectious Diseases Hospital Affiliated to Nanchang University, Nanchang City, China.
• Medicine (Baltimore). 2023 Mar 17; 102 (11): e33252e33252.

AbstractAcute-on-chronic liver failure (ACLF) is a common clinical emergency and critical illness with rapid progression and poor prognosis. This study aims to establish a more efficient system for the prognostic assessment of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), which will provide a guiding scheme for subsequent treatment and improve the survival rate of patients. Data on 623 patients with HBV-ACLF were recorded. Univariate and multivariate analyses were performed to determine the discriminative abilities of the novel prognostic assessment model in predicting 90-day mortality. The area under the receiver operating characteristic curve was used to evaluate the accuracy of the models. Patients were divided into high- and low-scoring groups based on the best critical values, and survival rates were analyzed using Kaplan-Meier survival analysis and compared by applying log-rank tests. The area under the curve of the new scoring system established using the results of the first reexamination, the results of the first examination, the mean daily change in these results (MDCR) and the results of other first examinations were 0.911 (95% confidence interval [CI]: 0.889, 0.933), 0.893 (95% CI: 0.868, 0.917), and 0.895 (95% CI: 0.871, 0.919), respectively. The final prognostic scoring system established using the results of the first reexamination was chosen as a novel prognostic assessment model, and patients with lower scores (first reexamination results [FRER] score ≤ 3.65) had longer survival times (P < .001). The prognostic scoring system established using the FRER combined with other examination results can better assess the prognosis of HBV-ACLF at 90 days.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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