Abstract
Background: Cirrhotic patients are at risk of severe complications. The CTP and MELD scores are commonly used but have certain limitations in short-term prognostication. The newly proposed CLIF-C AD score has shown good results in predicting short-term complications and mortality in decompensated cirrhosis patients. This study aims to evaluate the prognostic value of CLIF-C AD in predicting the risk of rehospitalization and mortality in patients at 1, 3, and 6 months. Methods and materials: A total of 110 decompensated cirrhosis patients admitted between June 2022 and January 2024 were treated and monitored at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital. The CTP, MELD, MELD-Na, and CLIF-C AD scores were assessed within 48 hours of hospital admission. The area under the ROC curve (AUC) was used to compare their predictive performance for cirrhosis-related events at 1, 3, and 6 months. Results: Among the 110 patients, cirrhosis was caused by alcohol (52.7%), hepatitis B (25.5%), hepatitis C (2.7%), and a combination of alcohol and viral hepatitis (19.1%). The primary decompensating events were ascites and variceal bleeding. The mean CLIF-C AD score was 51.31 ± 8.51. The CLIF-C AD score predicted rehospitalization better than CTP, MELD, and MELD-Na at 3 and 6 months (AUC: 0.751 and 0.718). Specifically, its predictive value for rehospitalization due to variceal bleeding at 3 months was AUC = 0.755. CLIF-C AD also showed prognostic value for mortality at all three time points, with AUC values of 0.691, 0.732, and 0.756, respectively. Conclusion: The CLIF-C AD score has a high prognostic value in predicting rehospitalization and is a reliable predictor of mortality in decompensated cirrhosis patients.
| Published | 2025-06-25 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | Vol. 15 No. 3 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.3.22 | |
| Keywords | xơ gan, tiên lượng, CLIF-C AD Cirrhosis, Prognostic, CLIF-C AD |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
Cheemerla S, Balakrishnan M. Global Epidemiology of Chronic Liver Disease. Clin Liver Dis (Hoboken). 2021;17(5):365-70.
Trần Văn Huy. Xơ gan. Giáo trình đại học Bệnh học nội khoa. Nhà xuất bản Đại học Huế; 2023. p. 100-10.
EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. Journal of hepatology2018. p. 406-60.
Jalan R, Pavesi M, et al. The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure. Journal of hepatology. 2015;62(4):831-40.
Durand F, Valla D. Assessment of prognosis of cirrhosis. Seminars in liver disease. 2008;28(1):110-22.
Baldin C, Piedade J, et al. CLIF-C AD Score Predicts Development of Acute Decompensations and Survival in Hospitalized Cirrhotic Patients. 2021;66(12):4525-35.
Garcia-Tsao G. The Child-Turcotte Classification: From Gestalt to Sophisticated Statistics and Back. Dig Dis Sci. 2016;61(11):3102-4.
Gülcicegi DE, Goeser T, Kasper P. Prognostic assessment of liver cirrhosis and its complications: current concepts and future perspectives. Front Med (Lausanne). 2023;10:1268102.
Võ Thị Minh Đức, Trần Văn Huy. Giá trị tiên lượng của chỉ số MELD ở bệnh nhân xơ gan Child Pugh C. Tạp chí Y Dược học. 2017; p. 119.
Nguyễn Thị Thuận. Nghiên cứu giá trị tiên lượng của chỉ số MESO ở bệnh nhân xơ gan mất bù tại Bệnh viện Đà Nẵng. Luận văn CKII, Trường Đại học Y Dược - Đại học Huế; 2022.
Antunes AG, Teixeira C, et al. Comparison of the prognostic value of Chronic Liver Failure Consortium scores and traditional models for predicting mortality in patients with cirrhosis. Gastroenterol Hepatol. 2017;40(4):276-85.
Lv Y, Wang Z, et al. Risk Stratification Based on Chronic Liver Failure Consortium Acute Decompensation Score in Patients With Child-Pugh B Cirrhosis and Acute Variceal Bleeding. Hepatology. 2021;73(4):1478-93.
Trebicka J, Fernandez J, et al. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology. Journal of hepatology. 2020;73(4):842-54.
Sturm L, Praktiknjo M, et al. Prognostic Value of the CLIF-C AD Score in Patients With Implantation of Transjugular Intrahepatic Portosystemic Shunt. Hepatol Commun. 2021;5(4):650-60.