Giá trị tiên lượng của thang điểm AARC ở bệnh nhân suy gan cấp trên nền mạn tính

Abstract

Objective: Evaluation of the 28-day mortality prognostic value of the AARC score and compare with MELD, Child-Pugh and CLIF-SOFA score in patients with acute-on-chronic liver failure. Subject and method: A descriptive observational study in the patients were diagnosed with acute-on-chronic liver failure. Calculate the AARC score, Child-Pugh, MELD, CLIF-SOFA at the first days of admission; 4^th and 7^th day of treatment. The evaluated outcome was 28-day mortality. Prognostic performance was evaluated using receiver operating characteristic (ROC) curves. Result: 38 patients were included. The AUROC value of the AARC score at day 1 (cutoff point 10.5); 4^th and 7^th day (cutoff point 9.5) were 0.782; 0.903 and 0.929. At the first day this value was higher than the AUROC value of CLIF-SOFA score (cutoff 9.5) and Child-Pugh score (10.5) with p of 0.84 and 0.03 respectively; lower than the AUROC value of the MELD score (cutoff point 31.5) with p=0.48. At 4^th and 7^th day, the AUROC value of AARC score was higher than that of CLIF-SOFA score, Child-Pugh score and MELD score with p of 0.83, respectively; 0.07; 0.27. Conclusion: The AARC score at the time of admission with a cutoff of 10.5 had a better predictive value of of 28-day mortality than the Child-Pugh scale; CLIF-SOFA but not equal to MELD scale. At day 4^th and day 7^th, AARC score with cutoff 9.5 has better predictive value of 28-day mortality than Child-Pugh scores; MELD; CLIF-SOFA.