ArticleThe Journal of international medical research2026
Development and validation of a dynamic prognostic score for hepatitis B virus-related acute-on-chronic liver failure.
Article in The Journal of international medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
ObjectiveHepatitis B virus-related acute-on-chronic liver failure is a rapidly progressive syndrome associated with high mortality. The aim of this study was to develop a dynamic prognostic score for precise outcome prediction in patients with hepatitis B virus-related acute-on-chronic liver failure.MethodsData from a single-center retrospective cohort were used to develop a dynamic prognostic score. The score was subsequently validated in an external multicenter prospective cohort.ResultsA total of 124 patients with hepatitis B virus-related acute-on-chronic liver failure were included in the derivation cohort. The change in the delta Chinese Severe Hepatitis B Research Group-acute-on-chronic liver failure II score between day 7 and baseline (δCOSSH-ACLF II 7-0) showed better predictive performance than the baseline Chinese Severe Hepatitis B Research Group-acute-on-chronic liver failure II score. Multivariate Cox regression analysis identified baseline total bilirubin, baseline prothrombin time international normalized ratio, and δCOSSH-ACLF II 7-0 as independent predictors of 90-day survival. We proposed a dynamic prognostic score calculated as follows: Dynamic prognostic score = 0.005 × total bilirubin + 0.609 × prothrombin time international normalized ratio + 1.234 × δCOSSH ACLF II 7-0. The area under the curves of the new score were 0.923 and 0.925 for predicting 28- and 90-day mortality, respectively. These findings were replicated in the validation cohort.ConclusionThe new prognostic score, based on dynamic changes in the clinical course, can accurately predict short-term mortality in patients with hepatitis B virus-elated acute-on-chronic liver failure.
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