Combining the serum lactic acid level and the lactate clearance rate into the CLIF-SOFA score for evaluating the short-term prognosis of HBV-related ACLF patients

Expert Rev Gastroenterol Hepatol. 2020 Jun;14(6):483-489. doi: 10.1080/17474124.2020.1763172. Epub 2020 May 20.

Abstract

Background: Acute-on-chronic liver failure due to hepatitis B virus infection is a subtype of liver failure. The aim of the current study was to investigate the clinical significance of serum lactic acid in combination with the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFA) for evaluating the short-term prognosis of HBV-related ACLF patients.

Research design and methods: The serum lactic acid level, the score model for end-stage liver disease (MELD), as well as the CLIF-SOFA of inpatients with HBV-related ACLF who were admitted to the Liver Disease Center of the First Affiliated Hospital of Fujian Medical University between 2009 and 2017 were analyzed.

Results: Three hundred and ninety-one HBV-related ACLF inpatients were measured. In the survival group, the lactate clearance rate measured over the course of 1 week post-admission was significantly higher than that measured for the death group. The area under the curve (AUC) for predicting the prognosis of HBV-related ACLF patients in short-term (within 3-month) with a baseline lactic acid level was 0.776.

Conclusions: Prediction performance of the short-term prognosis of HBV-related ACLF patients by combining the lactic acid level into the CLIF-SOFA score was significantly improved in comparison to using the CLIF-SOFA score alone.

Keywords: CLIF-SOFA score; Hepatitis B virus; end-stage liver disease; lactic acid; liver failure; prognosis.

MeSH terms

  • Acute-On-Chronic Liver Failure / blood*
  • Acute-On-Chronic Liver Failure / etiology
  • Acute-On-Chronic Liver Failure / metabolism
  • Acute-On-Chronic Liver Failure / mortality
  • Adult
  • Female
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / mortality
  • Humans
  • Lactic Acid / blood*
  • Lactic Acid / metabolism*
  • Male
  • Middle Aged
  • Multiple Organ Failure / blood
  • Multiple Organ Failure / diagnosis
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality
  • Organ Dysfunction Scores*
  • Predictive Value of Tests
  • Prognosis
  • Time Factors

Substances

  • Lactic Acid