ArticleJournal of clinical and translational hepatology2026
A Novel Simplified Prognostic Model for 90-day Transplant-free Survival in Patients with Severe Acute Liver Injury/Acute Liver Failure.
Article in Journal of clinical and translational hepatology, 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
Background and Aims: Early risk stratification of severe acute liver injury (SLI) that may progress to acute liver failure (ALF), is vital for timely intervention, but no universal prognostic assessment tool covers both conditions. This study aimed to develop a simplified prognostic model for early risk assessment in SLI/ALF patients. Methods: A retrospective cohort study consecutively enrolled SLI patients (including those progressing to ALF) from July 1, 2020 to May 31, 2025. Baseline clinical and laboratory data on admission were collected, with 90-day transplant-free survival as the primary outcome. Independent prognostic factors were screened via Cox regression to build a simplified scoring model, whose performance was compared with the Model for End-Stage Liver Disease (MELD), King's College Criteria (KCC), and the Acute Liver Failure Study Group Prognostic Index (ALFSG-PI). Results: Of 302 patients, 190 (62.9%) achieved 90-day transplant-free survival. Multivariate Cox regression identified international normalized ratio (hazard ratio [HR]: 1.118, 95% confidence interval [CI]: 1.050-1.191), platelet count (HR: 0.995, 95% CI: 0.993-0.998), and hepatic encephalopathy grade ≥ 2 (HR: 5.187, 95% CI: 3.403-7.907) as independent predictors, forming the HIP (derived from the above-mentioned three predictors) model. It showed good discrimination (area under the receiver operating characteristic curve [AUC]: 0.82), outperforming MELD (AUC: 0.76, Conclusions: The HIP model is a simple and effective tool for prognostic risk stratification in SLI/ALF patients, suitable for emergency and primary care to facilitate timely intervention.
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