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Matovic Zaric V, Pantic I, Lugonja S, Glisic T, Konjikusic S, Lolic I, Baljosevic N, Zgradic S, El Mezeni J, Vojnovic M, Brankovic M, Milovanovic T. Survival of Patients with Alcohol-Related Liver Disease Cirrhosis-Usefulness of the New Liver Mortality Inpatients Prognostic Score. Diagnostics (Basel) 2024;14:2508. [PMID: 39594174 PMCID: PMC11592997 DOI: 10.3390/diagnostics14222508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 11/03/2024] [Accepted: 11/04/2024] [Indexed: 11/28/2024] Open

Abstract

Background/Objectives: Alcohol can directly damage the liver, causing steatosis, steatohepatitis, cirrhosis, and hepatocellular cancer. The aim of this study was to examine 28-day survival in hospitalized patients with alcohol-related liver disease (ALD) cirrhosis, as well as to develop and validate a new survival prediction model. Methods: A total of 145 patients with ALD cirrhosis were included; 107 were diagnosed with acute decompensation (AD) and 38 with acute-on-chronic liver failure (ACLF). The new liver mortality inpatients (LIV-IN) score was calculated using the following variables: hepatic encephalopathy (HE), hepatorenal syndrome (HRS), ascites, systemic inflammatory response syndrome (SIRS), community-acquired infection (CAI), and fibrinogen. The diagnostic accuracy of the LIV-IN score was tested, along with the model for end-stage liver disease (MELD), model for end-stage liver disease-sodium (MELD-Na), albumin-bilirubin (ALBI), neutrophil-to-lymphocyte ratio (NLR), chronic liver failure consortium-C acute decompensation (CLIF-C AD), and chronic liver failure consortium-acute-on-chronic liver failure (CLIF-C ACLF). Results: Lethal outcome occurred in 46 (31.7%) patients. The mortality rate was higher in the ACLF group (n = 22, 57.9%) compared to the AD group (n = 24, 22.4%) (p < 0.01). The highest predictive power for short-term mortality was observed for the LIV-IN score (AUC 73.4%, p < 0.01). In patients with AD, the diagnostic accuracy of the CLIF-C AD score was better than for the LIV-IN score (AUC 0.699; p = 0.004, AUC 0.686; p = 0.007, respectively). In patients with ACLF, only the LIV-IN score had statistically significant discriminative power in predicting 28-day survival. Conclusions: The liver mortality inpatients prognostic score is a new, reliable prognostic model in predicting 28-day mortality.

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Affiliation(s)

Vera Matovic Zaric Emergency Center, Gastroenterology and Hepatology Department, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.L.); (N.B.)
Ivana Pantic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.P.); (T.G.); (S.Z.); (J.E.M.); (M.V.); (T.M.)
Sofija Lugonja Department of Internal Medicine, Division of Gastroenterology, General Hospital “Djordje Joanovic”, 23000 Zrenjanin, Serbia;
Tijana Glisic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.P.); (T.G.); (S.Z.); (J.E.M.); (M.V.); (T.M.) Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
Snezana Konjikusic FEFA Faculty, Metropolitan University, 11000 Belgrade, Serbia;
Iva Lolic Emergency Center, Gastroenterology and Hepatology Department, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.L.); (N.B.)
Nevena Baljosevic Emergency Center, Gastroenterology and Hepatology Department, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.L.); (N.B.)
Sanja Zgradic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.P.); (T.G.); (S.Z.); (J.E.M.); (M.V.); (T.M.)
Jasna El Mezeni Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.P.); (T.G.); (S.Z.); (J.E.M.); (M.V.); (T.M.)
Marko Vojnovic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.P.); (T.G.); (S.Z.); (J.E.M.); (M.V.); (T.M.)
Marija Brankovic Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia
Tamara Milovanovic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (I.P.); (T.G.); (S.Z.); (J.E.M.); (M.V.); (T.M.) Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;

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