THANG ĐIỂM CLIF – C AD TRONG TIÊN LƯỢNG BỆNH NHÂN XƠ GAN MẤT BÙ

Abstract

Cirrhosis is an important and leading cause of illness and death among individuals with chronic liver disease worldwide. Several prognostic scoring systems exist for patients with cirrhosis, among which the Chronic Liver Failure Consortium – Acute Decompensation (CLIF-C AD) score has demonstrated significant prognostic value in predicting outcomes at 28 days and 90 days. Objective: To investigate the value of the CLIF-C AD score as well as the Child-Pugh, MELD, and MELD-Sodium scores in predicting mortality among patients with decompensated cirrhosis.. Subjects and Methods: This was a prospective cohort study involving one hundred sixteen patients diagnosed with decompensated cirrhosis without ACLF. These patients were treated at the Gastroenterology–Hepatology Center of Bach Mai Hospital and the Department of Gastroenterology at Hanoi Medical University between July 2024 and April 2025. Results: Among 116 patients, 5 (4.3%) died within 28 days of admission, and 15 (12.9 %) died within 90 days. The optimal cutoff values for the CLIF-C AD score for risk stratification were determined to be 55 for predicting 28-day mortality, and 62 for predicting 90-day mortality. The CLIF-C AD score demonstrated excellent prognostic accuracy, with an Area Under the Receiver Operating Characteristic curve (AUROC) of 0.852 (p = 0.008) for 28-day mortality, and 0.803 (p = 0.001) for 90-day mortality—comparable to the performance of MELD and MELD-Na scores. Therefore, applying the CLIF-C AD score together with MELD and MELD-Na in clinical practice may help clinicians promptly identify high-risk patients who require intensive management from the outset.