Development and validation of a new prognostic model for patients with acute-on-chronic liver failure in intensive care unit

Table 3 Predictive values of prognostic scores for 28-day mortality in patients with acute-on-chronic liver failure

Scores	Youden index	Cutoff value	SEN (%)	SPE (%)	PPV (%)	NPV (%)	Brier score	R2 value	P in H-L test
Derivation set in MIMIC cohort	Development of MIMIC ACLF score
MIMIC ACLF	0.48	0.57	71.81	75.98	66.7	80.1	0.17	0.36	0.73
CLIF-C ACLF	0.40	59	65.43	74.56	63.2	76.3	0.19	0.26	0.70
MELD	0.38	27	73.14	65.12	58.4	78.4	0.20	0.20	0.04
MELD-Na	0.36	29	75.53	59.96	55.8	78.6	0.21	0.18	0.11
Validation set in MIMIC cohort	Internal validation
MIMIC ACLF	0.46	0.32	81.97	64.40	69.5	84.8	0.17	0.36	0.26
CLIF-C ACLF	0.40	61	55.74	84.29	69.4	74.9	0.19	0.26	0.92
MELD	0.37	27	72.13	64.40	56.4	78.3	0.20	0.21	0.67
MELD-Na	0.35	30	72.95	62.30	55.3	78.3	0.20	0.23	0.09
SHHMU cohort	External validation
MIMIC ACLF	0.49	1.51	65.22	84.00	71.4	79.7	0.17	0.34	0.84
CLIF-C ACLF	0.54	49	71.74	82.67	71.7	82.7	0.17	0.35	0.14
MELD	0.30	33	36.96	93.33	77.3	70.7	0.21	0.13	0.08
MELD-Na	0.44	34	60.87	82.67	68.3	77.5	0.20	0.22	0.52

SEN: Sensitivity; SPE: Specificity; PPV: Positive predictive value; NPV: Negative predictive value; H-L test: Hosmer-Lemeshow goodness-of-fit test; MIMIC: Medical Information Mart for Intensive Care; MELD: Model for End-stage Liver; CLIF-C: Chronic Liver Failure Consortium; ACLF: Acute-on-chronic liver failure; SHHMU: The Second Hospital of Hebei Medical University.