ArticleeGastroenterology2024
Evidence-based incorporation of key parameters into MELD score for acute-on-chronic liver failure.
Article in eGastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Characterization of the intrahepatic microbiome in patients with HBV-related end-stage liver disease.Virulence · 2026Article
- Sex- and Diabetes-Dependent Perioperative Model for End-Stage Liver Disease Trajectories Identify Distinct Hepatorenal Stress Phenotypes After Surgical Coronary Revascularization.Journal of clinical medicine · 2026Article
- Observational
- Clinical efficacy of empiric antibiotic therapy in Chinese patients with cirrhosis and bacterial infections: A multicenter study.PloS one · 2026Article
- Association of NPAR with 90-day mortality in predominantly acute-on-chronic liver failure.Frontiers in medicine · 2026Article
- Massive hepatic necrosis-associated acute liver failure.eGastroenterology · 2026Review
- Validation of the CLIF-SIG score in patients with HBV-related acutely decompensated cirrhosis.Gut · 2025Article
- Clinical, Microbiological, and Antibiotic Treatment Characteristics of Bacterial Infections in Patients with Liver Cirrhosis in China: A Multicenter Study.Journal of clinical and translational hepatology · 2025Article
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Authors and funding
45 authors.
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Abstract
Background: The model for end-stage liver disease (MELD) score is widely used for the prognostication in end-stage liver disease but has limited performance in acute-on-chronic liver failure (ACLF). In this study, we identified additional predictive parameters and reformed the MELD score to predict ACLF more accurately. Methods: A meta-analysis was performed on relevant studies to identify the predictive factors of 28-day/90-day outcomes of ACLF, which were validated in two large prospective cohorts. A prognostic score was developed by incorporating predictive parameters into the MELD score. The model was evaluated with a focus on discrimination and calibration. Results: The meta-analysis incorporated 32 cohort studies with a total of 13 939 patients, of which 13 risk factors were identified, and 3 risk factors (age, neutrophil count and hepatic encephalopathy (HE) grade) besides MELD score were validated in 751 patients with ACLF derived from two prospective cohorts. A new model (Chinese Acute-on-Chronic Liver Failure Consortium (CATCH-LIFE)-MELD score) was developed as follows: 0.028×age+0.3×HE grade+0.039×neutrophil count+0.079×MELD score. CATCH-LIFE-MELD score achieved a concordance index of 0.791/0.788 for 28-day/90-day outcomes, which is superior to other traditional scores. Other discrimination indices, including net reclassification improvement, integrated discrimination improvement and probability density function, and calibration including Nagelkerke's R Conclusions: CATCH-LIFE-MELD score, a modified MELD score exhibited improved accuracy in predicting the short-term prognosis of ACLF than other traditional scores.
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