Usefulness of the Variation of the CLIF-C ACLF Score in Patients With Acute on Chronic Liver Failure

Study Overview
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Brief Summary
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Patients with Acute on Chronic Liver Failure (ACLF) have high short-term mortality. The use of a severity score could define the patient's prognosis and would help determine in whom the treatment is effective or futile.

Detailed Description
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Acute on Chronic Liver Failure (ACLF) is a syndrome characterized by the presence of an acute decompensation of cirrhosis, associated with failure of at least one other organ or extra hepatic system. It is characterized by high mortality in the short term and its prevalence varies between countries and regions. It is an extraordinarily dynamic entity in which more than 50% of patients with less severe forms improve, while in those with 3 or more organ failures, the transplant rate is low and mortality is 90%. It is important to highlight that those patients with ACLF who manage to be transplanted have the same survival as cirrhotic patients without ACLF. There is no specific treatment, only life support and early determination of the precipitating factor and its eventual resolution. Having tools that define the short-term prognosis of these patients, especially the variation of the score (CLIF-C ACLF) during the first week, would have an important clinical relevance, because it can help define the patients who benefit from the supportive treatment and in whom the therapeutic effort is futile. The biomarker Neutrophil Gelatinase-Associated Lipocalin (NGAL) is increased in plasma and urine in patients with ACLF and could help improve the prognostic ability of the CLIF-C ACLF score.

Official Title
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Usefulness of the Variation of the CLIF-C ACLF Score in Patients With Acute on Chronic Liver Failure

Conditions
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Acute-On-Chronic Liver Failure

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute on Chronic Liver Failure Exclusion Criteria: Acute liver failure, terminal disease, pregnancy, previous liver transplant

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluate the degree of severity of the ACLF with the CLIF-C ACLF score at the time of diagnosis and its variation on day 3 and 7 | The severity of the ACLF will be assessed by means of a score (CLIF_C ACLF) at the time of admission, day three and seven. Good evolution of the score will be considered when it decreases and bad evolution when it remains the same or increases. | one week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlate the variation of the score (CLIF-C ACLF) and mortality at 28, 60 and 90 days. | The variation of the score (good or bad evolution) will be correlated with mortality at 28, 60 and 90 days. | 90 days | 
| ACLF epidemiological evaluation. | Incidence, prevalence of ACLF will be determined. Triggers (hepatic and / or extra hepatic causes). | 90 days | 
| Correlate the level of NGAL with the development of ACLF and its severity evaluated by the CLIF-C ACLF score. | The level of NGAL in plasma and urine will be determined routinely at the time of diagnosis | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute-On-Chronic Liver Failure, Liver Failure