Scoring systems predict the prognosis of acute-on-chronic hepatitis B liver failure: an evidence-based review

Expert Rev Gastroenterol Hepatol. 2014 Aug;8(6):623-32. doi: 10.1586/17474124.2014.906899. Epub 2014 Apr 24.

Abstract

Acute-on-chronic hepatitis B liver failure is a devastating condition that is associated with mortality rates of over 50% and is consequent to acute exacerbation of chronic hepatitis B in patients with previously diagnosed or undiagnosed chronic liver disease. Liver transplantation is the definitive treatment to lower mortality rate, but there is a great imbalance between donation and potential recipients. An early and accurate prognostic system based on the integration of laboratory indicators, clinical events and some mathematic logistic equations is needed to optimize treatment for patients. As parts of the scoring systems, the MELD was the most common and the donor-MELD was the most innovative for patients on the waiting list for liver transplantation. This review aims to highlight the various features and prognostic capabilities of these scoring systems.

Keywords: Child-Turcotte-Pugh score; King’s College Criteria; acute-on-chronic hepatitis B liver failure; artificial neural network; donor-MELD; liver transplantation; model for end-stage liver disease; prognosis; regression scoring models; scoring systems; sequential organ failure assessment.

Publication types

  • Review

MeSH terms

  • Acute-On-Chronic Liver Failure / diagnosis*
  • Acute-On-Chronic Liver Failure / surgery
  • Acute-On-Chronic Liver Failure / virology
  • Decision Support Techniques*
  • Evidence-Based Medicine
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnosis*
  • Hepatitis B, Chronic / surgery
  • Humans
  • Liver Transplantation
  • Logistic Models
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Waiting Lists