ALTA: a simple nutritional prognostic score for patients with hepatitis B virus-related acute-on-chronic liver failure
作者全名：Song, Rui; Wang, Xiaohao; Li, Zhao; Wu, Hongyu; Tan, Jiahe; Tan, Junyi; Li, Hanlu; Zeng, Teng; Ren, Hong; Chen, Zhiwei
作者地址：[Song, Rui; Wang, Xiaohao; Ren, Hong; Chen, Zhiwei] Chongqing Med Univ, Affiliated Hosp 2, Key Lab Mol Biol Infect Dis,Dept Infect Dis, Chinese Minist Educ,Inst Viral Hepatitis, Chongqing, Peoples R China; [Li, Zhao] Seventh Peoples Hosp Chongqing, Dept Gastroenterol, Chongqing, Peoples R China; [Wu, Hongyu] Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 2, Chongqing, Peoples R China; [Tan, Jiahe] Chongqing Med Univ, Dept Neurosurg, Affiliated Hosp 1, Chongqing, Peoples R China; [Tan, Junyi; Li, Hanlu] Ninth Peoples Hosp Chongqing, Dept Infect Dis, Chongqing, Peoples R China; [Zeng, Teng] Fifth Peoples Hosp Chongqing, Dept Infect Dis, Chongqing, Peoples R China
通信作者：Ren, H; Chen, ZW (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Key Lab Mol Biol Infect Dis,Dept Infect Dis, Chinese Minist Educ,Inst Viral Hepatitis, Chongqing, Peoples R China.
来源：FRONTIERS IN NUTRITION
ESI学科分类：CLINICAL MEDICINE
WOS号：WOS:001206984600001
JCR分区：Q2
影响因子：4
年份：2024
卷号：11
期号：
开始页：
结束页：
文献类型：Article
关键词：acute-on-chronic liver failure; hepatitis B virus; prognostic score; nutrition; mortality
摘要：Background Malnutrition, despite being a common complication, is often neglected in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The objective of this study was to develop a simplified nutritional prognostic score to accurately predict mortality in HBV-ACLF patients. Methods In this multicenter retrospective study, clinical data from 530 HBV-ACLF patients were used to create a new prognostic score, which was then validated in two external cohorts (n = 229 and 248). Results Four independent factors were significantly associated with 28-day mortality in HBV-ACLF patients, forming a novel prognostic score (ALTA score = 0.187 x age-0.849 x lymphocyte count-2.033 x total cholesterol-0.148 x albumin-0.971). Notably, the AUROC of ALTA score for 28/90-day mortality (0.950/0.967) were significantly higher than those of three other ACLF prognostic scores (COSSH-ACLF II, 0.864/0.734; MELD, 0.525/0.488; MELD-Na, 0.546/0.517; all P < 0.001), and three known nutritional scores (CONUT, 0.739/0.861; OPNI, 0.279/0.157; NRS-2002, 0.322/0.286; all P < 0.001). The prediction error rates of ALTA score for 28-day mortality were significantly lower than COSSH-ACLF II (7.3%), MELD (14.4%), MELD-Na (12.7%), CONUT (9.0%), OPNI (30.6%), and NRS2002 (34.1%) scores. Further classifying ALTA score into two strata, the hazard ratios of mortality at 28/90 days were notably increased in the high-risk groups compared to the low-risk group (15.959 and 5.740). These results were then validated in two external cohorts. Conclusion ALTA, as a simplified nutritional prognostic score for HBV-ACLF, demonstrates superiority over the COSSH-ACLF II and other scores in predicting short-term mortality among HBV-ACLF patients. Therefore, it may be used to guide clinical management, particularly in primary care settings.
基金机构：Natural Science Foundation of Chongqing [CSTB2023NSCQ-MSX0715]; Postgraduate Research and Innovation Projects of Chongqing Municipal Education Commission [CYS20197]; Second Affiliated Hospital of Chongqing Medical University; First batch of key Disciplines on Public Health in Chongqing, Health Commission of Chongqing, China
基金资助正文：The authors declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of Chongqing (Grant No. CSTB2023NSCQ-MSX0715) and the Postgraduate Research and Innovation Projects of Chongqing Municipal Education Commission (CYS20197). Remarkable Innovation-Clinical Research Project, The Second Affiliated Hospital of Chongqing Medical University, and The First batch of key Disciplines on Public Health in Chongqing, Health Commission of Chongqing, China.
