Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2022; 14(2): 420-428
Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.420
Modified EASL-CLIF criteria that is easier to use and perform better to prognosticate acute-on-chronic liver failure
Paul J Thuluvath, Feng Li
Paul J Thuluvath, Feng Li, Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, MD 21202, United States
Paul J Thuluvath, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21202, United States
Author contributions: Thuluvath PJ contributed to the study concept, design, analysis, interpretation of data, and drafting of the manuscript; Li F did the statistical analysis, contributed to the interpretation of data, and drafted the statistical part of the manuscript.
Institutional review board statement: The study was done using a national database (UNOS) that is publicly available. The datasets are de-identified and therefore exempt from IRB approval.
Informed consent statement: This study is based on a de-identified national database (UNOS) and informed consent is not applicable.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Available to public from the UNOS.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paul J Thuluvath, FAASLD, AGAF, FACG, FRCP, Professor, Institute of Digestive Health and Liver Diseases, Mercy Medical Center, 301 Saint Paul Place, Baltimore, MD 21202, United States. thuluvath@gmail.com
Received: October 26, 2021
Peer-review started: October 26, 2021
First decision: December 27, 2021
Revised: January 1, 2022
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: February 27, 2022
Core Tip

Core Tip: There is no consensus on the best definition for acute-on-chronic liver failure (ACLF). The most common definition used in the literature is the one proposed European Association for the Study of the Liver-Chronic Liver Failure Consortium (EASL-CLIF) consortium. One problem with those criteria is that it is not very user-friendly. We have shown that EASL-CLIF criteria for ACLF could be simplified without losing its sensitivity and ability to prognosticate 30-d all-cause and transplant-free mortality. We believe that modified EASL-CLIF criteria; the modified criteria that we propose are easier to use than the EASL-CLIF criteria and also have a better prognostic capability.