Pediatric Chronic Liver Failure-Sequential Organ Failure Assessment Score and Outcome of Children with Chronic Liver Disease Admitted to Intensive Care Unit

Background: Chronic liver diseases (CLD) in children are a growing public health concerns, with potential long-term im-plications. When complications of CLD are severe, end stage liver disease (ESLD) often occurs and admission to the inten-sive care unit (ICU) is often required for organ support and management. For predicting the prognosis of end-stage liver disease, many prognostic models were proposed. Pediatric chronic liver failure-sequential organ failure assessment (pC-LIF-SOFA) scoring system was formulated by European Asso-ciation for the Study of the Liver-Chronic Liver Failure Con-sortium (EASL-CLIF) to predict mortality in ACLF patient. Aim of Study: This study aimed to assess the predictive value of the pediatric CLIF-SOFA (pCLIF-SOFA) score in de-termining the outcome of children with chronic liver disease (CLD) admitted to the ICU. Patients and Methods: A prospective study was conducted on 100 children with CLD admitted to the Pediatric Hepatolo-gy, Gastroenterology, and Nutrition Department, National Liv-er Institute, Menoufia University. Patients were divided into deceased and surviving groups based on the outcome. Results: Various demographic and clinical characteristics were found among the patients, with pneumonia being the most common cause for admission to the ICU. The outcome showed no significant correlation with age and sex, but sig-nificant correlations were observed with various clinical pa-rameters such as the general appearance, body temperature, pulse rate, and respiratory rate. Higher mortality rates were associated with certain clinical manifestations e.g. tachypnea, tachycardia, jaundice, hypotension, pallor and the need for me-chanical ventilation, need for blood element transfusion and vasoactive drugs. The study also demonstrated a strong cor-relation between the severity of hepatic encephalopathy and mortality, as well as the benefit of using pediatric CLIF-SOFA score in predicting short-term outcomes compared to liver spe-cific scores like the Pediatric End-Stage Liver Disease model (PELD) and The Model for End-Stage Liver Disease (MELD). Conclusion: In conclusion, organ failure-based scoring systems like pediatric CLIF-SOFA are better predictor of short-term mortality in children with advanced CLD compared to PELD/MELD.