Utility of the MAYO End-Stage Liver Disease Score, King's College Criteria, and a New In-Hospital Mortality Score in the Prognosis of In-Hospital Mortality in Acute Liver Failure

M. Peláez-Luna, J. Martinez-Salgado, M. A. Olivera-Martinez

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28 Citations (Scopus)

Abstract

Introduction: Several prognostic scores attempt to aid in the selection of patients with acute liver failure (ALF) to be treated either medically or by liver transplantation; however, their lack of fulfillment does not predict spontaneous survival in ALF and refined prognostic criteria are needed to improve such selection. Our aim was to evaluate and compare a new ALF in-hospital mortality prediction score versus King's College Criteria (KCC) and model for End-Stage Disease (MELD) score. Methods: First-time ALF-diagnosed individuals admitted to our institution (n = 58) were grouped according their final outcome as "alive" or "death," and those significantly different variables between groups entered into a logistic regression and lineal regression models. An ALF in-hospital mortality score (ALFIHMS) was produced and its sensitivity, specificity, and area under receiver operator characteristics were compared with those of KCC and MELD scores. Results: Since no significant differences (P = .81) in mortality rates between fulminant and subfulminant hepatic failure were found, no further analysis according to ALF's classification was performed. After obtaining and comparing ALFIHMS with KCC and MELD, we found that ALFIHMS prediction accuracy is higher than that of KCC and MELD score and that an ALFIHMS cutoff point >15 points is associated with an in-hospital mortality probability >50%. Conclusions: ALFIHMS has higher prognostic accuracy than KCC and MELD scores in ALF.

Original languageEnglish (US)
Pages (from-to)927-929
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number3
DOIs
StatePublished - Apr 1 2006

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End Stage Liver Disease
Acute Liver Failure
Hospital Mortality
Liver Transplantation
Patient Selection
Logistic Models
Sensitivity and Specificity
Mortality

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

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title = "Utility of the MAYO End-Stage Liver Disease Score, King's College Criteria, and a New In-Hospital Mortality Score in the Prognosis of In-Hospital Mortality in Acute Liver Failure",
abstract = "Introduction: Several prognostic scores attempt to aid in the selection of patients with acute liver failure (ALF) to be treated either medically or by liver transplantation; however, their lack of fulfillment does not predict spontaneous survival in ALF and refined prognostic criteria are needed to improve such selection. Our aim was to evaluate and compare a new ALF in-hospital mortality prediction score versus King's College Criteria (KCC) and model for End-Stage Disease (MELD) score. Methods: First-time ALF-diagnosed individuals admitted to our institution (n = 58) were grouped according their final outcome as {"}alive{"} or {"}death,{"} and those significantly different variables between groups entered into a logistic regression and lineal regression models. An ALF in-hospital mortality score (ALFIHMS) was produced and its sensitivity, specificity, and area under receiver operator characteristics were compared with those of KCC and MELD scores. Results: Since no significant differences (P = .81) in mortality rates between fulminant and subfulminant hepatic failure were found, no further analysis according to ALF's classification was performed. After obtaining and comparing ALFIHMS with KCC and MELD, we found that ALFIHMS prediction accuracy is higher than that of KCC and MELD score and that an ALFIHMS cutoff point >15 points is associated with an in-hospital mortality probability >50{\%}. Conclusions: ALFIHMS has higher prognostic accuracy than KCC and MELD scores in ALF.",
author = "M. Pel{\'a}ez-Luna and J. Martinez-Salgado and Olivera-Martinez, {M. A.}",
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T1 - Utility of the MAYO End-Stage Liver Disease Score, King's College Criteria, and a New In-Hospital Mortality Score in the Prognosis of In-Hospital Mortality in Acute Liver Failure

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AU - Martinez-Salgado, J.

AU - Olivera-Martinez, M. A.

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N2 - Introduction: Several prognostic scores attempt to aid in the selection of patients with acute liver failure (ALF) to be treated either medically or by liver transplantation; however, their lack of fulfillment does not predict spontaneous survival in ALF and refined prognostic criteria are needed to improve such selection. Our aim was to evaluate and compare a new ALF in-hospital mortality prediction score versus King's College Criteria (KCC) and model for End-Stage Disease (MELD) score. Methods: First-time ALF-diagnosed individuals admitted to our institution (n = 58) were grouped according their final outcome as "alive" or "death," and those significantly different variables between groups entered into a logistic regression and lineal regression models. An ALF in-hospital mortality score (ALFIHMS) was produced and its sensitivity, specificity, and area under receiver operator characteristics were compared with those of KCC and MELD scores. Results: Since no significant differences (P = .81) in mortality rates between fulminant and subfulminant hepatic failure were found, no further analysis according to ALF's classification was performed. After obtaining and comparing ALFIHMS with KCC and MELD, we found that ALFIHMS prediction accuracy is higher than that of KCC and MELD score and that an ALFIHMS cutoff point >15 points is associated with an in-hospital mortality probability >50%. Conclusions: ALFIHMS has higher prognostic accuracy than KCC and MELD scores in ALF.

AB - Introduction: Several prognostic scores attempt to aid in the selection of patients with acute liver failure (ALF) to be treated either medically or by liver transplantation; however, their lack of fulfillment does not predict spontaneous survival in ALF and refined prognostic criteria are needed to improve such selection. Our aim was to evaluate and compare a new ALF in-hospital mortality prediction score versus King's College Criteria (KCC) and model for End-Stage Disease (MELD) score. Methods: First-time ALF-diagnosed individuals admitted to our institution (n = 58) were grouped according their final outcome as "alive" or "death," and those significantly different variables between groups entered into a logistic regression and lineal regression models. An ALF in-hospital mortality score (ALFIHMS) was produced and its sensitivity, specificity, and area under receiver operator characteristics were compared with those of KCC and MELD scores. Results: Since no significant differences (P = .81) in mortality rates between fulminant and subfulminant hepatic failure were found, no further analysis according to ALF's classification was performed. After obtaining and comparing ALFIHMS with KCC and MELD, we found that ALFIHMS prediction accuracy is higher than that of KCC and MELD score and that an ALFIHMS cutoff point >15 points is associated with an in-hospital mortality probability >50%. Conclusions: ALFIHMS has higher prognostic accuracy than KCC and MELD scores in ALF.

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