Dhiman RK, Agrawal S, Gupta T, Duseja A, Chawla Y. 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. World J Gastroenterol 2014; 20(40): 14934-14941 [PMID: 25356054 DOI: 10.3748/wjg.v20.i40.14934]
Corresponding Author of This Article
Radha K Dhiman, MD, DM, FAMS, FACG, Professor, Department of Hepatology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. rkpsdhiman@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Gastroenterol. Oct 28, 2014; 20(40): 14934-14941 Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14934
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
Radha K Dhiman, Swastik Agrawal, Tarana Gupta, Ajay Duseja, Yogesh Chawla, Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Dhiman RK conceived the idea for the study, performed analyses, interpreted data and prepared the manuscript; Agrawal S and Gupta T were responsible for data collection, analyses, interpreting data, and assisted in preparing the manuscript; Duseja A and Chawla Y assisted the interpretation of the data and in the preparation of the manuscript; all authors were involved in patient care management.
Correspondence to: Radha K Dhiman, MD, DM, FAMS, FACG, Professor, Department of Hepatology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. rkpsdhiman@hotmail.com
Telephone: +91-99-14209337 Fax: +91-17-22744401
Received: March 25, 2014 Revised: May 8, 2014 Accepted: June 12, 2014 Published online: October 28, 2014 Processing time: 218 Days and 0.6 Hours
Core Tip
Core tip: The most common acute precipitant for acute-on-chronic liver failure (ACLF) is infection. The Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) criteria is better than Asia-Pacific Association for the Study of Liver criteria in defining ACLF as the CLIF-SOFA criteria identifies patients with a high likelihood of mortality who could benefit from liver transplantation or inclusion into trials of newer therapeutic modalities. Mortality increases with increasing grades of ACLF based on number of organ failures in Asian-Indian patients similar to the results seen in the European population. Also, the multi-organ failure CLIF-SOFA score is better than liver specific Model for End-Stage Liver Disease and Child-Pugh scores, suggesting that ACLF leads to multi-organ failure and is not limited to the liver.
