Systematic Reviews
Copyright ©The Author(s) 2022.
World J Hepatol. Dec 27, 2022; 14(12): 2025-2043
Published online Dec 27, 2022. doi: 10.4254/wjh.v14.i12.2025
Table 4 Summary of selected studies
Kuo et al[65]2021TaiwanAssess the predictive value and clinical reliability of three different scoresACLF patients admitted to the ICUNon-survivor: CLIF-C ACLF, CLIF-C ACLF lactate, and CLIF-C ACLF-D were 58.85 ± 11.40, 60.88 ± 13.71, and 34.03 ± 1.57, respectively. Survivor: 44.55 ± 9.14, 46.91 ± 11.66, and 32.29 ± 1.17, respectively, (all P values < 0.01)The CLIF-C ACLF-D score may be a better predictor of short- and long-term mortality
Li et al[66]2017ChinaAssess various prognostic scores, such as the CLIF-C OFs, CLIF-SOFAs, CLIF-C ACLFs, ACLF grade, and MELD, predicted short-term (28-d) mortalityCHB patients with ACLFScores in no ACLF group and for ACLF group grades 1, 2, and 3, respectively: CLIF-C OFs: 7, 9, 10, and 13; CLIF-C ACLFs: 29, 37, 44, and 60; CLIF-SOFAs: 5, 7, 9, and 13; MELDs: 16, 22, 30, and 37CLIF-C OF score outperforms other scores
Dong et al[67]2020ChinaDetermine the characteristics and outcomes of ACLFACLF patients who have or do not have cirrhosisCOSSH ACLF score (AUROC = 0.778 or 0.792, 95%CI 0.706-0.839 or 0.721–0.851) displayed the better prognostic ability for EASL ACLF patients with non-cirrhosis. CLIF-C ACLF score (AUROC = 0.757 or 0.796, 95%CI 0.701–0.807 or 0.743-0.843) still was the best prognostic scoring system in EASL ACLF patients with cirrhosisCLIF-C ACLF score was better at predicting short-term mortality in ACLF patients with cirrhosis, while the COSSH ACLF score was better for ACLF patients without cirrhosis
Grochot et al[68]2020BrazilDetermine the accuracy of the presence of ACLF in predicting mortality.Patients with cirrhosisCLIF-SOFA score at 28-, 90-, and 365-d was 1.32, 1.3, and 1.2, respectively. CLIF-C AD/ACLF score was 1.0, 1.0, and 1.0, respectivelyCLIF-SOFA score increased mortality by 1.3 times for each point
Jacques et al[41]2020BrazilAssess and compare the liver-specific scores ability to predict mortalityCirrhotic patients with SBPCLIF-SOFA was able to predict mortality at 30-, 90-, and 365-d, with an AUROC of 0.75, 0.64, and 0.64, respectively. CLIF-C AD or CLIF ACLF scores 0.59, 0.51, and 0.52, respectivelyCLIF-SOFA outperformed other liver-specific measures
Terres et al[39]2022BrazilAssess and compare the significance of liver-specific scores in predicting mortalityHRS patients who received terlipressinCTP at 30-, 90- and 365-d mortality 0.76, 0.75 and 0.72, respectively. CLIF-SOFA 0.66, 0.63, and 0.57. CLIF-C ACLF 0.60, 0.55, and 0.53. MELD 0.67, 0.64, and 0.5. MELD-Na 0.65, 0.63, and 0.52CTP was able to predict increased mortality at 30-, 90- and 365-d
Terres et al[40]2021BrazilEvaluate the liver-specific scores to predict mortalityAOVH patients who received terlipressinAUROC at 30- and 90-d: MELD-Na 0.77 and 0.78. CLIF-SOFA 0.76 and 0.75. CLIF-C AD or ACLF 0.64 and 0.60. MELD 0.75 and 0.77. CTP 0.75 and 0.76CLIF-SOFA was better in ACLF patients. CTP performed better in AD patients
Grochot et al[56]2019BrazilAssess the validity of CLIF SOFA in predicting mortality and compare it to other liver-specific scoresAD and ACLF patientsAUROC at 28-, 90- and 365-d, respectively: CLIF-SOFA 0.71, 0.75 and 0.66. CLIF-C AD/ACLF 0.52, 0.51, and 0.56. MELD 0.54, 0.50, and 0.52. MELD-Na 0.57, 0.54, and 0.55CLIF-SOFA predicted 90-d mortality better than other scores
Jacques et al[69]2021BrazilEvaluate the relation between ACLF and mortalityCirrhotic patients with SBPScores for 28- and 90-d mortality, respectively: MELD 0.83 and 0.87. CLIF-SOFA 1.1 and 1.1. CTP 31 and 8.3 Elevated CLIF-SOFA scores and the presence of ACLF were related to higher 28- and 90-d mortality
Engelmann et al[21]2018United KingdomAssess if the currently available scores can identify patients with ACLFPatients with ACLFAUROC of 28-d mortality prediction: CLIF-C ACLF 0.8. CLIF-C OF 0.75. MELD, 0.68. CP 0.66CLIF-C ACLF accurately predicted 28-d mortality
Barosa et al[70]2017PortugalEvaluate CLIF-C ACLF, MELD, MELD-Na, and CTP scores for short/medium-term mortality, to identify ACLF frequency and to compare mortality between non-ACLF and ACLF patientsPatients admitted for AD of cirrhosisCut-off point in 28- and 90-d mortality, respectively: CLIF-C ACLF 50 and 50. CTP 10 and 10. MELD 17 and 14. MELD-Na 22 and 22CLIF-C ACLF score outperformed other scores
Ferreira Cardoso et al[71]2019PortugalValidate the EASL-CLIF C scoresPatients with and without ACLFAUROC for CLIF-C ACLF score for 28-d mortality was (0.856 ± 0.071)CLIF-C AD score of 60 was related to an increased risk of developing ACLF
Maipang et al[57]2019ThailandAssess ACLF prognostic models and investigation of their discriminative capacities in ACLF patientsCirrhotic patients with AD and ACLFScores for 28-d, 90-d, 6-mo, and 1-yr mortality, respectively: CLIF-SOFA: 0.84, 0.85, 0.80, 0.80. CLIF-C OF: 0.83, 0.82, 0.78, and 0.78. CLIF-C ACLF: 0.79, 0.80, 0.77, and 0.77. CTP: 0.7, 0.67, 0.64, and 0.63. MELD: 0.63, 0.60, 0.56, and 0.56. MELD-Na: 0.63, 0.59, 0.56, and 0.56. iMELD: 0.73, 0.71, 0.67, and 0.68. APACHE II: 0.69, 0.65, 0.63, and 0.63The CLIF-SOFA had similar predictive accuracy for 28-d mortality as the CLIF-C OF
Li et al[36]2016ChinaAssess if CLIF-C OFs criteria can be used to identify patients and if the CLIF-C ACLF score can be used to predict prognosisHBV cirrhotic patients with ACLFAssess patients with ACLF for 28-, 90-, 180-, and 360-d mortality, respectively: HBV-ACLF: 0.654, 0.645, 0.644, and 0.640. CLIF-C ACLF: 0.704, 0.685, 0.687, and 0.682. MELD: 0.554, 0.543, 0.543, and 0.540. MELD-Na: 0.549, 0.541, 0.541, and 0.537. Patients without ACLF: for 28-, 90-, 180-, and 360-d mortality, respectively: HBV-AD: 0.737, 0.716, 0.720, and 0.721. CLIF-C AD: 0.733, 0.724, 0.728, and 0.728. MELD: 0.667, 0.653, 0.657, and 0.639. MELD-Na: 0.719, 0.710, 0.701, and 0.682CLIF-C ACLFs were found to be more accurate in predicting short-term mortality
Chirapongsathorn et al[49]2022ThailandCollect epidemiological data and assess a scoring system for predicting mortalityACLF patients.AUROC of prognostic scores for 30- and 90-d mortality, respectively: CLIF-SOFA: 0.64 and 0.61 (95%CI: 0.585-0.704). CLIF-OF: 0.62 and 0.59. CLIF-C: 0.62 and 0.61. MELD: 0.60 and 0.56. MELD-Na: 0.60 and 0.57CLIF-SOFA score had a higher AUROC than the other scores
Zhang et al[31]2018ChinaAssess bacterial infection and predictors of mortalityACLF patients with autoimmune liver diseaseCLIF-SOFA score for 28-d mortality was 1.362 and 1.093, respectively.Scores for 90-d mortality were, respectively: CLIF-SOFA 2.936 and 1.578. MELD 1.232 and 0.664. CP 2.003 and 0.595All scores of ACLF patients with bacterial infection were high
Shin et al[72]2020South KoreaTo look into the risk factors for mortality in cirrhotic patients and to see how ACLF affected their prognosisCirrhotic patients with variceal bleedingPrediction of mortality at 28- and 90-d with AUROC were, respectively: CTP 0.842 and 0.846. MELD 0.857 and 0.867. MELD-Na 0.828 and 0.834. CLIF-SOFA 0.895 (95%CI, 0.829-0.962) and 0.897 (95%CI, 0.842-0.951)CLIF-SOFA model well predicted 28-d or 90-d mortality
Gao et al[73]2018ChinaInvestigate the CLIF-SOFA lung score's predictive value and determine the best voriconazole regimenACLF patients with IPACLIF-SOFA 10 (P = 0.083). CLIF-C ACLF 46.8 (P = 0.028). MELD 27.2 (P = 0.145). MELD-Na 28.6 (P = 0.064)Patients with a CLIF-SOFA lung score of less than 2 had a superior 28-d survival rate than those with a lung score of more than 1 (P = 0.001)
Chen et al[74]2021ChinaCreate a predictive nomogramHBV-ACLF patients undergoing LTCP score (0.626), MELD (0.627), MELD-Na (0.583), CLIF-C OF (0.674), and CLIF-C ACLF (0.684)The nomogram's concordance index for predicting 1-yr survival was 0.707, which was significantly greater than that of other prognostic models. The nomogram could be helpful in determining which HBV-ACLF patients may improve after LT
Yu et al[75]2021ChinaMulticenter study to develop and evaluate a novel scoring system that uses baseline and dynamic data to predict short-term prognosisACLF patientsFor 90-d prognosis: DP-ACLF with an AUC value of 0.907, CTP (0.601/74.6%), MELD (0.721/76.2%), MELD-Na (0.740/73.8%), CLIF-SOFA (0.701/76.9%), CLIF-C ACLF (0.694/74.6%), and COSSH-ACLF (0.724/77.7%) (P < 0.001)The validation group had a higher predictive accuracy of DP-ACLF on ACLF prognosis and an accuracy rate of 85.4%, according to ROC analysis
Liu et al[35]2020ChinaAssess different prognostic models to predict short-term mortalityACLF patientsThe AUROCS of the CLIF-SOFA score, PWR, ALBI score, and MELD score was 0.804, 0.759, 0.710, and 0.670, respectivelyCLIF-SOFA was the best model for predicting 28-d mortality
Zhang et al[76]2015ChinaExamine and contrast the various ACLF diagnostic criteria currently in use. Also, to identify predictors of the progress from ACLF at enrolment defined by APASL alone or by both APASL and CMASelected patients were cirrhotic, fulfilling at least APASL criteria for ACLFCTP 12 and 11 (P = 0.53). MELD 17.8 and 16.0 (P = 0.02). MELD-Na 20.1 and 18.7 (P = 0.02). CLIF-SOFA 7 and 7 (P = 0.01)The maximum rise in the CLIF-SOFA score, MELD-Na score, and total bilirubin were all independent predictors of progression into post-enrollment EASL-CLIF ACLF from ACLF at enrollment
Li et al[77]2020ChinaRandomized study to assess the scoring systems for predicting short-term resultsHBV-ACLF patientsALBI score (30-d mortality: HR = 3.452; 90-d mortality: HR = 3.822), MELD (30-d mortality: HR = 1.073; 90-d mortality: HR = 1.082), CLIF-C ACLF score (30-d mortality: HR = 1.061; 90-d mortality: HR = 1.065)All scores accurately predicted 30-d and 90-d mortality. A higher CLIF-C ACLF score was linked to a lower overall survival rate
Zhang et al[14]2020ChinaFind prognostic scores that can be used to predict short- and long-term outcomesACLF patients with cirrhosisScores for survivors and [non-survivors] at 28-d, 3- and 6-mo, respectively: CTP 10 [12] (P = 0.001), 10 [11] (P = 0.028) and 10 [11] (P = 0.033). MELD 16 [24] (P = 0.004), 15 [23] (P = 0.001) and 15 [23] (p=0.002). MELD-Na 18 [24] (P = 0.081), 16.54 [23.27] (P = 0.011) and 17.27 [23] (P = 0.020). CLIF-C OF 9 [11] (P = < 0.001), 9 [10.00] (P = 0.001) and 9 [10] (P = 0.001). CLIF-SOFA 8 [12] (P ≤ 0.001), 8.55 [11.46] (P ≤ 0.001) and 8.53 [11.33] (P ≤ 0.001). CLIF-C ACLF 45.01 [53.98] (P ≤ 0.001), 44.39 [52.85] (P ≤ 0.001) and 44.11 [52.56] (P = 0.001)The CLIF-SOFA score was particularly useful for assessing 28-d mortality
Kim et al[42]2016South KoreaA comparative study to evaluate the performance of suggested ACLF-specific scores in predicting short-term mortalityAlcoholic hepatitis patientsThe AUROC of CLIF-SOFA, CLIF-C OFs, DF, ABIC, GAHS, MELD, and MELD-Na was 0.86 (0.81-0.90), 0.89 (0.84-0.92), 0.79 (0.74-0.84), 0.78 (0.72-0.83), 0.81 (0.76-0.86), 0.83 (0.78-0.88), and 0.83 (0.78-0.88), respectively, for 28-d mortality. CLIF-SOFA score of 8 had (78.1% Sn and 79.7% Sp), and CLIF-C OFs of 10 had (68.8% Sn and 91.4% Sp) for predicting 28-d mortalityCLIF-SOFA and CLIF-C OF scores performed well for short-term mortality
Costa E Silva et al[78]2021BrazilAssess how well prognostic scores predict mortalityCirrhotic patients admitted to the ICUAUC revealed in all patients: CTP 0.701, APACHE II 0.695, MELD 0.727, MELD-Na 0.729, MESO index 0.723, iMELD 0.640, SOFA 0.753, CLIF-SOFA 0.776, CLIF-C OF 0.807 and CCI 0.627. CLIF-C OF in ACLF patients (0.749). CLIF-SOFA in AD patients (0.716) and CLIF-C AD (0.695)CLIF-C OF and CLIF-SOFA had the best ability to predict mortality in all patients
Chen et al[38]2020TaiwanCompare the eight prognostic scoresCirrhotic patients with ACLFScore on admission to ICU median (IQR) (P ≤ 0.001): CTP 9.0, MELD 23.0, CLIF-C OF 10.0, CLIF-C ACLF 49.2, SAP III 51.0, MPM0-III 0.0 (P = 0.001), APACHE II 16.0, and APACHE III 81.0. Predict overall mortality by AUROC: CTP 0.719, MELD 0.702, CLIF-C OF 0.721, CLIF-C ACLF 0.772, MPM0-III 0.607, SAP III 0.739, APACHE II 0.756 and APACHE III 0.817APACHE III and CLIF-C ACLF scores were superior to other models for predicting overall mortality
Sheng et al[79]2021ChinaCreate a new and effective prognosis model and identify new prognostic factorsHRS with AD patientsAUROC in derivation and validation, respectively: GIMNS (0.830 and 0.732), MELD (0.759 and 0.623), CLIF-SOFA (0.767 and 0.661), COSSH-ACLF (0.759 and 0.674). Mortality at 28-d according to the developed GIMNS score: (GIMNS ≥ 2) 100.0%, (GIMNS 1-2) 73.8%, (GIMNS 0-1) 57.1% and (GIMNS < 0) 30.3%GIMNS had a higher accuracy AUROC and outperformed MELD and CLIF-SOFA
Hong et al[80]2016South KoreaEvaluate the features and outcomes of ACLF patientsACLF patients with underlying liver diseaseScores in Type A (non-cirrhosis), B (cirrhosis), and C (cirrhosis with the previous decompensation), respectively: MELD 29, 27 and 26. Hepatic CLIF-SOFA 19, 34 and 21. Extra-hepatic CLIF-SOFA 7, 11 and 31The 30-d overall survival rate for types A, B, and C, respectively, was 85.3%, 81.1%, and 83.7%
Sy et al[54]2016CanadaAssess if the CLIF-SOFA score could predict survivalSeverely ill patients with ACLFAPACHE II 23; MELD 26; CTP 12; SOFA 15 and CLIF-SOFA 17. The CLIF-SOFA (AUROC 0.865). SOFA (AUROC 0.935)CLIF-SOFA outperformed the other scores
Cai et al[2]2019ChinaEvaluate prognostic scoring models and create prediction modelsVarious causes of AD in cirrhotic patientsHepatitis B group, AUROC for 28-d mortality for MELD, CLIF-C-AD, MELD-Na, AARC-ACLF, and the newly developed AD scores was 0.663, 0.673, 0.657, 0.662, and 0.773, respectively. Alcoholic liver disease group, 0.731, 0.737, 0.735, 0.689, and 0.778, respectively. Others group 0.765, 0.767, 0.814, 0.720, and 0.814, respectivelyIn predicting the prognosis of AD cirrhosis, the newly developed scoring models for short-term mortality outperformed the other models
Marciano et al[81]2017ArgentinaCompare the predictive accuracy for 28- and 90-d transplant-free mortality of a modified CLIF-SOFA score with that of the classic CLIF-SOFA and KDIGO scoresAKI in cirrhotic patients with ADClassic CLIF-SOFA and modified CLIF-SOFA by AUCROC: In 28-d transplant-free, 0.93 and 0.92 (P = 0.34), respectively. In 90-d transplant-free, 0.79 and 0.78 (P = 0.78), respectively. In AKI 28-d and 90-d transplant-free mortality by AUCROC, 0.67 (P = 0.002) and 0.63 (P = 0.02)Both CLIF-SOFA scores were extremely accurate in predicting 28-d and 90-d transplant-free mortality
Xu et al[82]2018ChinaRecognizing mortality risk variables and optimizing stratification are crucial for increasing survival ratesCirrhotic patients with pneumoniaScores by AUROC for predicting mortality in 30-d and 90-d respectively: CLIF-SOFA 0.890 and 0.900. MELD 0.853 and 0.889. MELD-Na 0.801 and 0.849, qSOFA 0.854 and 0.777, PSI 0.867 and 0.831. CTP 0.726 and 0.768CLIF-SOFA outperformed the other models in predicting mortality
Silva et al[83]2021BrazilAssess the prognostic scores predicting mortalityCirrhotic patients who were admitted to the ICU without being pre-screenedROC curves SOFA 0.88, MELD-Na 0.76, MELD 0.75, CPS 0.71 and SAPS 3 (0.51). In patients with ACLF, CLIF-ACLF 0.74, CLIF-OF 0.70, MELD-Na 0.73 and MELD 0.69, SAPS 3 (0.55), SOFA 0.63 and CLIF-SOFA 0.66In patients with and without ACLF, CLIF-ACLF and SOFA had higher accuracy in predicting mortality
McPhail et al[46]2015United KingdomCompare the capabilities of SOFA and CLIF-SOFA scores to predict patient survival and evaluate CLIF-SOFACirrhotic patientsAt the time of admission, with AUROC values, CLIF-SOFA and SOFA scores were 0.813 and 0.799, respectively. At 48 h after admission were 0.853 and 0.840, respectively. After 1 wk were 0.842 and 0.844, respectivelySOFA and CLIF-SOFA scores appear to have equal ability to predict patient survival
Yang et al[52]2022ChinaEstimate the short-term prognosis of ACLF patientsACLF patients who had undergone LTAUROC of MELDs 0.704, ABIC: 0.607, CLIF-C OFs 0.606, CLIF-C ACLFs 0.653 and CLIF-SOFAs 0.633 of the 90-d outcomeMELDs had a higher AUROC than others for predicting the 90-d outcome in ACLF patients after LT
Moreau et al[15]201312 European countriesMulticenter study to establish ACLF diagnostic criteria and characterize the progression of the diseaseCirrhotic patients with ADThe increased 28-d mortality rate was linked to three risk variables identified from the CLIF-SOFA score at enrollment: ≥ 2 organ failures, kidney failure alone, a combination of renal dysfunction, and a single organ failure other than kidney and/or hepatic encephalopathy (mild-moderate)In patients with ACLF, higher CLIF-SOFA scores and leukocyte counts were predictors of mortality. The mortality rates at 28-d and 90-d, respectively: No ACLF 4.7% and 14%. ACLF g1: 22.1% and 40.7%. ACLF g2: 32% and 52.3%. ACLF g3: 76.7% and 79.1%
Li et al[37]2021ChinaCreate a new simple prognostic score that can accurately predict outcomesHBV-ACLF patientsThe C-indices of the new score for 28- and 90-d mortality (0.826 and 0.809), COSSH-ACLF 0.793 and 0.784; CLIF-C ACLF 0.792 and 0.770; MELD 0.731 and 0.727; MELD-Na 0.730 and 0.726 (all P < 0.05)The C-indices of the new score were significantly higher than other existing scores for 28-d and 90-d mortality
Perdigoto et al[58]2019Identify and characterize ACLF, and compare the CLIF-C OF score to the MELD-Na and the CP score. Also, to assess the CLIF-C ACLF and CLIF-C AD scoresPatients with ACLFIn the whole study group, the AUC: For 28-d mortality, the scores MELD, CLIF-C OF, and CP were 0.908, 0.844, and 0.753, respectively. For 90-d mortality 0.902, 0.814, and 0.724, respectively (P < 0.0001 for AUC in all scores)CLIF-C OF shows good accuracy and diagnoses ACLF. MELD performed better in terms of 90-d mortality prediction
Ramzan et al[84]2020Evaluate the CLIF-C CLF score and compare it to the MELD scoreACLF patients in ICUMELD scores 30, 40 and 50 at 48 h were 0.532, 0.594 and 0.529, respectively. CLIF-C ACLF ≥ 70 at 0 h, 24 h, and 48 h were 0.498, 0.605, and 0.643, respectivelyCLIF-C ACLF score of 70 or higher accurately predicts mortality
Verma et al[85]2021Assess the prognostic modelsACLF patientsDay-7 AARC model had the numerically highest c-index, 0.872, best accuracy of 84.0%, Day-7 NACSELD-ACLF sensitivity (100%) but with a lower PPV (70%) for mortalityPatients having an AARC score of > 12 on day 7 had the lowest 30-d survival rate. All model performance parameters were better on day 7
Picon et al[59]2017BrazilAssess prognostic scoresPatients with AD of cirrhosis and ACLFPatients with ACLF, at 28-d from the diagnosis: CLIF-C ACLF with an AUC of 0.71. Patients with AD, regarding 28-d mortality: CLIF-C AD 0.75; CP 0.72; MELD 0.75; MELD-Na 0.76; CLIF-C OF 0.74. Patients with AD regarding 90-d mortality: CLIF-C AD 0.70; CP 0.73; MELD 0.7; MELD-Na 0.73; CLIF-C OF 0.65The CLIF-C ACLF score is the most accurate for predicting 28-d death in patients with ACLF. The CLIF-C AD score was also good in predicting death in cirrhosis with AD
Gupta et al[44]2017IndiaAssess the variations in mortality outcomes and predictorsPatients admitted with AD and ACLF caused by hepatic or extra-hepatic insultsAUROC for 28-d mortality in the extrahepatic ACLF group for CLIF-SOFA, MELD, iMELD, APACHE-11, and CTP was 0.788, 0.724, 0.718, 0.634, and 0.726, respectively. AUROC for 28-d mortality in the hepatic ACLF group for CLIF-SOFA, MELD, iMELD, APACHE-11, and CTP was 0.786, 0.625, 0.802, 0.761, and 0.648, respectivelyiMELD and CLIF-SOFA were the best for predicting 28-d mortality
Niewiński et al[45]2020PolandUse the available prognostic scores to find the best mortality risk factor(s)Critically unwell ACLF patientsPredictive 90-d mortality: MELD 1.10, SOFA 1.33, CLIF-SOFA 1.40, and CLIF-C OF 1.64SOFA score surpassed the CLIF-C values
Kulkarni et al[55]2018IndiaDetermine the in-hospital predictors of 28-d mortalityACLF patients admitted to the Medical ICUMELD 0.783 (Sn 75% and Sp 82.1%). CLIF-SOFA 0.947 (Sn 83.3% and Sp 96.4%). CTP 0.795 (Sn 94.4% and Sp 57.1%). APACHE-II 0.876 (Sn 91.6% and Sp 78.5%)CLIF-SOFA and APACHE-II scores had a superior ability to predict mortality
Dhiman et al[86]2014IndiaAssess the efficacy of the CLIF-SOFA and APASL definitions of ACLF in predicting the short-term prognosis of ACLF patientsPatients selected were cirrhotic with ADAUROCs for 28-d mortality were 0.795, 0.787, 0.739, and 0.710 for CLIF-SOFA, APACHE-II, CTP, and MELD, respectivelyThe strongest predictor of short-term mortality was the CLIF-SOFA score
Safi et al[87]2018GermanyEvaluate how infection detected at the time of admission, as well as other clinical baseline factors, affected the mortalityCirrhotic patients with emergency admissionsPredictors of mortality up to 90 d (all patients): HR, 95%Cl, and P, respectively: SOFA 0.15, 0.03-0.69 and 0.015. CLIF C ACLF 1.09, 1.06-1.13 and < 0.001. Infection and CLIF-SOFA and infection and CLIF-C-ACLF: HR, 95%CI and P, respectively: CLIF-SOFA 1.33, 1.17- 1.51 and < 0.001 CLIF-SOFA: Infection 0.85, 0.71-1.02 and 0.074. CLIF-C-ACLF 1.09, 1.06-1.12 and < 0.001 CLIF-C-ACLF: Infection 0.96, 0.92-1.01 and 0.082Infection reduced the significant relation between mortality and CLIF-C-ACLF or CLIF-SOFA-score
Leão et al[88]2019BrazilAssess how different ACLF diagnostic criteria performed in terms of predicting mortalityCirrhotic patients with ADAUROC at 28-d for CLIF-C, AARC and NACSELD criteria were 0.710, 0.560 and 0.561 (P = 0.002), respectively. AUROC at 90-d mortality were 0.760, 0.554 and 0.555 respectively (P < 0.001)CLIF-C performed better in predicting mortality at 28-d and 90-d
Bartoletti et al[89]2018Different European countriesSummarize the current epidemiology of BSI, and assess predictors of 30-d mortality and antibiotic resistance risk factorsCirrhotic patientsIn a Cox regression model, CLIF-SOFA scores were (HR 1.35; 95%CI 1.28-1.43; P < 0.001)The SOFA and CLIF-SOFA scores were the best predictors of 30-d mortality
Mendizabal et al[47]202111 Latin American countriesEvaluate whether SARS-CoV-2 infection affects the outcome and assess the effectiveness of the different prognostic models in predicting mortalityHospitalized cirrhotic patientsAUROC for performance evaluation in predicting 28-d mortality for CLIF-C, NACSELD, CTP score and MELD-Na were 0.85, 0.75, 0.69, 0.67; respectively (P < 0.0001)In patients with cirrhosis and SARS-CoV-2 infection, CLIF-C performed better than other models