Predictive value of the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score in the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure

Abstract

Background: As a large, prospective, multicenter study-based prognostic score for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score (COSSH-ACLFs), has been approved by some foreign scholars; however, its predictive value needs to be verified. This study investigated the predictive value of COSSH-ACLFs for short-term prognosis in Chinese patients with HBV-ACLF. Methods: This retrospective cohort study included 751 patients with HBV-ACLF admitted to the Fifth Medical Center of Chinese PLA General Hospital between January 2011 and December 2014. Spearman method was used to assess the correlation of COSSH-ACLFs with classical scores. Different COX multivariate regression models were used to confirm the relationship between COSSH-ACLFs and short-term prognosis in patients with HBV-ACLF, and stratified analysis was used to further verify the stability of this relationship. We compared the predictive powers of COSSH-ACLFs and other classical scores using area under the receiver operating characteristic curve (AUROC) and Z- test. Results: A total of 975 patients with HBV-ACLF were screened, and 751 were analyzed (623 male and 128 female). COSSH-ACLFs was the highest in patients with end-stage ACLF, followed by those with middle- and early-stage ACLF ( H = 211.8, P < 0.001). In the fully adjusted model, COX multivariate regression analysis revealed that COSSH-ACLFs (as a continuous variable) was independently and positively correlated with mortality risk in patients with HBV-ACLF at 28 days (hazard ratio [HR]: 1.37 [1.22, 1.53], P < 0.001) and 90 days (HR: 1.43 [1.29, 1.58], P < 0.001). The same trend could be observed in the crude model and minimally adjusted model. The AUROCs of COSSH-ACLFs for 28-day and 90-day prognoses in patients with HBV-ACLF were 0.807 and 0.792, respectively, indicating a stronger predictive accuracy than those of classic models. Conclusions: COSSH-ACLFs, with a superior predictive accuracy compared with other classical scores, can strongly predict short-term prognosis in Chinese patients with HBV-ACLF.

Low Testosterone Levels Predict Increasing Severity and Worse Outcomes of Hepatitis B Virus-related Acute-on-chronic Liver Failure in Males

“…The two severity scores that we evaluated are both based on biochemical and clinical indicators and have been preliminarily validated for severity assessments of HBV-ACLF cohorts. The COSSH-ACLF system was developed speci cally for such cohorts and was found this to be one of the best systems for monitoring the progression of HBV-ACLF [6,31]. Our results demonstrate that TT is strongly negatively correlated with the two severity scores, meaning that lower TT indicates more advanced HBV-ACLF.…”

Risk factors for underlying comorbidities and complications in patients with hepatitis B virus-related acute-on-chronic liver failure

“…In the AARC data, HE was present in approximately 40% of patients with HBV-ACLF [ 28 ]. Several other studies have shown that the incidence of HE was 17.2–57.2% [ 10 , 29 ]. In our study, 19.44% of patients had HE on admission, while 39.84% developed HE during hospitalisation.…”

Cortisol in Peripheral Blood Predicts the Severity and Prognosis in Patients with Liver Failure at 90 Days

“…Risk Management and Healthcare Policy 2021:14 4312 minutes at 37°C; (4) the microtiter plate was washed four times; (5) 50 μL of substrate A and 50 μL of substrate B was added to each well. All were gently mixed and incubated for 15 minutes at 37°C, protected from the light; (6) 50 μL stop solution was added to each well; (7) Optical Density (OD) was read at 450 nm using a microtiter plate reader within 15 minutes.…”

“…Hepatitis B virus (HBV) is the leading cause of liver failure in China, and the mortality rate ranges from 50%-80%. [5][6][7] It has been reported that patients with liver failure have a very high mortality rate at 90 days of illness. [8][9][10] At present, there is no effective treatment except liver transplantation.…”