Background Acute-on-chronic liver failure (ACLF), which is characterized by rapid deterioration of liver function and multiorgan failure, has high mortality. This study was designed to identify prognostic scores to predict short-term and long-term outcome in patients with ACLF to facilitate early treatment and thereby improve patient survival. Materials and Methods We retrospectively analyzed 102 ACLF patients who were hospitalized in the gastroenterology department. The EASL-CLIF criteria were used to define the ACLF. The demographic characteristics and biochemical examination results of the patients were acquired, and seven scores (CTP score, MELD score, MELD-Na, CLIF ACLF score, CLIF-C OF score, and CLIF SOFA score) were calculated 24 h after admission. All patients were observed until loss to follow-up, death, or specific follow-up times (28 days, 3 months, and 6 months), which were calculated after the initial hospital admission. The receiver operating characteristic (ROC) curve was employed to estimate the power of six scores to forecast ACLF patients’ outcome. Results All scores were distinctly higher in nonsurviving patients than in surviving patients and had predictive value for outcome in patients with ACLF at all time points (P < 0.050). The areas under the ROC curve (AUROCs) of the CLIF-SOFA score were higher than those of other scores at all time points. The comparison of the AUROC of the CLIF-SOFA score with other scores was statistically significant at 28 days (P < 0.050), which was the only time point at which it was greater than 0.800. Conclusion Patients with ACLF have high mortality. These six scores are effective tools for assessing the prognosis of ACLF patients. The CLIF-SOFA score is especially effective for evaluating 28-day mortality.

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评估预测慢加急性肝衰竭患者死亡率的预后评分：一项回顾性研究

背景 慢加急性肝衰竭（ACLF）以肝功能快速恶化和多器官衰竭为特征，病死率高。本研究旨在确定预后评分，以预测 ACLF 患者的短期和长期结果，以促进早期治疗，从而提高患者生存率。材料与方法 我们回顾性分析了消化内科住院的 102 例 ACLF 患者。EASL-CLIF 标准用于定义 ACLF。获取患者的人口学特征和生化检查结果，入院后24 h计算7个评分（CTP评分、MELD评分、MELD-Na、CLIF ACLF评分、CLIF-C OF评分、CLIF SOFA评分）。观察所有患者直至失访、死亡、或具体的随访时间（28 天、3 个月和 6 个月），这些时间是在初次入院后计算的。受试者工作特征 (ROC) 曲线用于估计六个分数的功效，以预测 ACLF 患者的结果。结果 非存活患者的所有评分均明显高于存活患者，并且在所有时间点对 ACLF 患者的预后具有预测价值（P < 0.050）。CLIF-SOFA评分的ROC曲线下面积（AUROCs）在所有时间点均高于其他评分。CLIF-SOFA评分的AUROC与其他评分的比较在第28天有统计学意义（P < 0.050），是唯一大于0.800的时间点。结论 ACLF患者死亡率较高。这六个评分是评估 ACLF 患者预后的有效工具。CLIF-SOFA 评分对于评估 28 天死亡率特别有效。