ACCURACY OF CHRONIC LIVER FAILURE CONSORTIUM (CLIF-C) ACLF SCORE COMPARED WITH MELD, MELD-NA AND CTP AS A MORTALITY PREDICTOR IN ACUTE ON CHRONIC LIVER FAILURE PATIENTS ADMITTED TO TERTIARY RURAL CARE HOSPITAL
Creators: name: Batra, Nitish
Publisher: name: Zenodo
Year: 2023
Subjects: Acute-on chronic liver failure (ACLF), cirrhosis, organ failure, MELD, MELD – Na

description: <strong>ABSTRACT</strong> <em>Background</em> Live failure is a complex entity involving biochemical and histological evidence. Acute on chronic liver failure is a term used for sudden decompensation of underlying liver disease, leading to multiple complications such as encephalopathy, ascites and bleeding manifestations. The severity of same can be assessed using different kind of scoring system such as Child Pugh score, MELD score, MELD-Na and CLIF. Most of these systems involve parameters like serum bilirubin, prothrombin time, serum albumin and total leukocyte count. <strong>Main body</strong> <strong>Introduction</strong> Acute-on chronic liver failure (ACLF) is defined by sudden decompensation of cirrhosis, organ failure and high short-term mortality.(1) 30% of patients admitted with cirrhosis land in ACLF, which is associated with a 28-day mortality rate. Studies have shown systemic inflammation provides the basis for new investigations regarding mechanism and management of this syndrome.(2) The main aim in general management of ACLF patients is timely identification and triggering factors of ACLF. (3) Various scoring systems for predicting morbidity and mortality in ACLF patients include CLIF-C ACLF, MELD, MELD-sodium (MELD-Na), and Child- Turcotte - Pugh (CTPs) scores. CLIF-C scoring system includes multiple components: age, WBC count and organ failure (bilirubin, creatinine, grade of hepatic encephalopathy, PT INR, Mean arterial pressure and PaO2/FiO2 ratio). Patients with a CLIF-C ACLF score of 39 or lower had a 95.1 percent likelihood of remaining alive, while those with a score of 51 or higher had a percent likelihood of passing away within one month. In this scenario, the new CLIF ratings were better than their predecessors MELD, MELD-Na, and CTP at predicting short- and medium-term mortality. There is paucity of data on CLIF-C in ACLFs. The rationale of this study is that we will demonstrate the accuracy of CLIF-C ACLFs scoring system compared to other scoring systems in Indian Rural population. In a tertiary care referral health center like ours, most acute on chronic liver failure patients do not come in the early phase and are referred later in the course of disease. Because of the abovementioned knowledge gaps, we wanted to see how these scores and biochemical markers predict the outcomes in these patients. <strong>AIM </strong> Accuracy of Chronic Liver Failure Consortium (CLIF-C) ACLF score compared with MELD, MELD-Na and CTP as a Mortality Predictor in Acute on Chronic Liver Failure patients admitted to tertiary rural care hospital <strong><em>Objectives </em></strong> 1. To estimate CLIF-C ACLF score, MELD, MELD-sodium (MELD-Na), and Child-Pugh (CPs) score in Acute on Chronic Liver Failure patients. 2. To compare the sensitivity, and specificity of CLIF-C scoring system with MELD, MELD-sodium (MELD-Na), and Child- Turcotte - Pugh (CTPs) ME as 28 day mortality indicator more accurately in cases of acute on chronic liver failure.