Prognostic Value of CLIF-C of Score in Patients with ACLF (Acute on Top of Chronic Liver Cell Failure)

Abstract Background ACLF is a major cause of mortality in patients with cirrhosis and chronic liver disease worldwide. An international consensus definition for ACLF is currently lacking and thus there is heterogeneity in how these patients are identified and subsequently managed in different settings. Whilst it is clear that early diagnosis, prevention of precipitating factors, and aggressive ICU care with organ support improves prognosis; treatment for ACLF is currently broadly restricted essentially to supportive care. Objective To evaluate the prognostic accuracy of CLIF-C ACLF score in determining short-term (28-day) mortality in patients with acute on top of chronic liver cell failure presented to Ain Shams University Hospitals. Methods This was a retrospective cohort study that was carried out in Ain Shams university hospitals (Tropical Medicine Department, Intermediate Care unit). 70 patients (47 males, 23 females) were studied in retrospective manner in the period from 12/2019 to 12/2021 in the form of collecting records of patients with Acute on top of Chronic liver cell failure ACLF to evaluate the prognostic value of CLIF C ACLF score in patients with ACLF to predict the 28 day mortality. Results CLIF-C ACLF score has shown better accuracy in predicting short term 28 day mortality for patients with ACLF compared with all other tested prognostic scores for chronic liver disease in patients with ACLF, especially for ACLF grade 3. Conclusion ACLF-specific scores could significantly predict in-hospital mortality of patients with ACLF. However, CLIF-C ACLF and Child-Pugh class C were superior to other scores as they could significantly and independently predict in- hospital mortality. Cirrhosis patients who were hospitalized due to acute liver decompensation with or without ACLF had a high short-term mortality rate. The CLIF-C ACLF score demonstrated the best accuracy in predicting the prognosis of ACLF patients. The prognosis of AD patients was poorer than that of other populations.