CLIF-SOFA SCORING SYSTEM IN PREDICTING SHORT- TERM MORTALITY IN PATIENT WITH LIVER CIRRHOSIS
*Prashant Mani Tripathi, Robin Maskey and Bickram Pradhan
ABSTRACT
Background: Patients of Liver Cirrhosis who are hospitalized for decompensation and organ failure are at high risk of short term death. Mortality rates at 28 days and 90 days in patients with acute decompensation are 33.9% and 51.2% respectively. In this study we aimed to assess the outcome of Cirrhosis patient according to CLIF-SOFA scoring system and to compare CLIF-SOFA scoring system with three conventional prognostic models [MELD, MELD-Na and Child Turcotte-Pugh (CTP)]) in predicting short term mortality in Cirrhotics. Methodology: All the patients admitted with a diagnosis of Liver Cirrhosis from 1st March 2015 to 30th April 2016 were enrolled and evaluated in detail. The CLIF-SOFA score, Child Turcotte-Pugh, MELD and MELD-Na scores was calculated in each patient within 24 hours and patient were followed for 4 weeks to determine 4 week mortality. Results: Among 95 patients of Liver cirrhosis, 20 (21%) patients died during 4 week period. The mortality rates in different CLIF SOFA stages were I- 0%, II- 13.3%, III- 69.2%, IV- 90% (p value <0.001). This study showed that CLIF-SOFA outperforms all 3 scoring system in predicting 4 week mortality by displaying highest area under the ROC curve .974 (95 confidence interval- .947- 1.000). Area under the ROC curve for MELD-Na, MELD and CTP were .864 (.758- .970), .851 (.749- .953) and .711 (.602- .819) respectively. Thus CLIF-SOFA is the best measure of predicting short term (4 week) mortality followed by MELD-Na, MELD and CTP scores respectively. Conclusion: CLIF SOFA score is better than MELD- Na, MELD score, and CTP class in predicting 4 week mortality.
Keywords: Liver Cirrhosis, CLIF SOFA score, MELD score, MELD- Na score, CTP class.
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