Validation of CLIF-C ACLF score to define a threshold for futility of intensive care support for patients with acute-on-chronic liver failure

Table 1 Clinical parameters according to survival status after 28 days

Parameter	Alive (n = 103)	Dead (n = 99)	p Value
Male sex, n (%)	70 (68%)	66 (67%)	p = 0.85
Age, years	50 ± 12	53 ± 11	p = 0.19
MELD score	23 ± 9	30 ± 10	p < 0.0001
Child-Pugh score	10.5 ± 1.7	11.9 ± 1.6	p < 0.0001
Child-Pugh classification, A/B/C, n (%)^a	2/28/73 (2%/27%/71%)	0/8/90 (0%/8%/92%)	p = 0.001
CLIF-OF score	11 (9–12)	13 (11–14)	p < 0.0001
CLIF-C ACLF score	50.6 ± 7.3	58.4 ± 9.6	p < 0.0001
Number of organ failures, 1–3/4–6, n (%)	101/2 (98%/2%)	77/22 (78%/22%)	p < 0.0001
Renal replacement, n (%)	26 (25%)	41 (41%)	p = 0.02
HE classification, 0–2/3–4^b, n (%)	91/12 (88%/12%)	78/21 (79%/21%)	p = 0.07
Bilirubin, mg/dl; μmol/L	3.4 (1.6–9.1); 58 (27–156)	7.8 (3.5–15.5); 133 (60–265)	p < 0.001
INR	1.8 (1.5–2.3)	2.2 (1.9–3.1)	p < 0.0001
Albumin, g/dl; g/L	2.6 ± 0.7; 26 ± 7	2.5 ± 0.7; 25 ± 7	p = 0.23
Platelet count, 10⁹/L	87 (57–137)	80 (53–119)	p = 0.17
Sodium, mmol/L	138 ± 9	137 ± 10	p = 0.20
Serum creatinine, mg/dl; μmol/L	0.9 (0.7–1.6); 80 (62–142)	1.5 (0.9–2.4); 133 (80–212)	p = 0.002
WBC count, 10⁹/L	9.4 (6.3–15.1)	10.2 (6.3–16.5)	p = 0.37

Abbreviations: ACLF Acute-on-Chronic Liver Failure, CLIF European Foundation for the study of chronic liver failure, HE Hepatic encephalopathy, INR International normalized ratio, MELD Model for End-Stage Liver Disease, OF Organ failure, WBC White blood cell
Categorical variables are displayed in percent and continuous variables as mean ± SD (normally distributed data) or median (IQR) (nonparametric testing)
Ascites grades: 0 = no ascites/slight ascites; 1 = moderate ascites; 2 = severe/refractory ascites
^aNo patient in ACLF 3 was allocated to Child-Pugh class A
^bClassification according to West Haven Criteria [25]

ISSN: 1364-8535