Chronic Liver Failure-Sequential Organ Failure Assessment is better than the Asia-Pacific Association for the Study of Liver criteria for defining acute-on-chronic liver failure and predicting outcome

Table 1 Characteristics of study population

Characteristics	n = 50
Age (yr)	46 ± 131
Male gender	43 (86)2
Cause of cirrhosis
Alcohol	29 (58)
Hepatitis C virus + alcohol	5 (10)
Autoimmune	3 (6)
Hepatitis B virus	3 (6)
Wilson	3 (6)
Cryptogenic	7 (14)
Acute precipitating event
Sepsis	33 (66)
Active alcoholism	20 (40)
Autoimmune flare	2 (4)
Hepatitis B virus flare	2 (4)
Upper gastrointestinal bleed	2 (4)
Acute hepatitis E virus infection	1 (2)
Cytomegalovirus infection	1 (2)
Unknown	4 (8)
More than one cause	15 (30)
Type of acute decompensation
Sepsis	33 (66)
Ascites	8 (16)
Hepatic encephalopathy	17 (34)
Upper gastrointestinal bleed	5 (10)
More than one decompensation	13 (26)
Prior decompensation	28 (56)
Bilirubin (mg/dL)	13.2 (0.6-43.0)3
Total leukocyte count (/mm3)	10100 (2700-39000)
Platelet count (103/mm3)	90.0 (14.4-444.0)
International normalized ratio	2.5 ± 0.8
Serum creatinine (mg/dL)	1.6 (0.5-7.9)
Jaundice	45 (90)
Ascites	42 (84)
Hepatic encephalopathy	17 (34)
Upper gastrointestinal bleed	6 (12)
Organ failures
Liver	29 (58)
Kidney	22 (44)
Cerebral	5 (10)
Coagulation	23 (46)
Respiratory	2 (4)
Circulation	2 (4)
≥ 2 organ failures	14 (28)
Prognostic scores
Child-Pugh score	11.4 ± 1.7
MELD score	29.2 ± 7.8
APACHE II score	13.0 (4.0-41.0)
CLIF-SOFA score	9.9 ± 2.7
Mortality
28-d mortality	19 (38)
90-d mortality	29 (58)

¹mean ± SD;

²Number (percentage);

³Median (range). APACHE: Acute Physiology and Chronic Health Evaluation; CLIF-SOFA: Chronic Liver Failure-Sequential Organ Failure Assessment; MELD: Model for End-Stage Liver Disease.