Value of Chinese Group on the Study of Severe Hepatitis B-acute-on-chronic liver failure Ⅱ score in predicting the short-term prognosis of patients with acute-on-chronic liver failure comorbid with hepatic encephalopathy

Tong HUANG; Yubo ZHAO; Ling YANG

doi:10.12449/JCH250821

Volume 41 Issue 8

Aug. 2025

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Article Navigation > Journal of Clinical Hepatology > 2025 > 41(8): 1615-1619

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Value of Chinese Group on the Study of Severe Hepatitis B-acute-on-chronic liver failure Ⅱ score in predicting the short-term prognosis of patients with acute-on-chronic liver failure comorbid with hepatic encephalopathy

DOI: 10.12449/JCH250821

Tong HUANG¹,
Yubo ZHAO²,
Ling YANG^{3
,
,
,}

1.
Department of Infectious Diseases The First Hospital of Shanxi Medical University，Taiyuan 030001，China
2.
Department of Hepatobiliary Surgery The First Hospital of Shanxi Medical University，Taiyuan 030001，China
3.
Department of Anesthesiology The First Hospital of Shanxi Medical University，Taiyuan 030001，China

Research funding:

Beijing Gando Charity Foundation (iGandanF-1082023-RGG010)

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Corresponding author: YANG Ling， 2777673937@qq.com （ORCID： 0009-0002-3656-8776）
Received Date: 2024-12-26
Accepted Date: 2025-01-20
Published Date: 2025-08-25

Abstract

Abstract

Objective To investigate the value of Chinese Group on the Study of Severe Hepatitis B-acute-on-chronic liver failure Ⅱ （COSSH-ACLF Ⅱ） score in predicting the short-term prognosis of patients with hepatitis B virus-related acute chronic liver failure （HBV-ACLF） comorbid with hepatic encephalopathy （HE）. Methods A retrospective analysis was performed for 134 patients who were admitted to The First Hospital of Shanxi Medical University from January 2019 to October 2024 and were diagnosed with HBV-ACLF and HE， and according to the survival status of the patients on day 90 of follow-up， they were divided into survival group with 60 patients and death group with 74 patients. Related scores were calculated， including COSSH-ACLF Ⅱ score， COSSH-ACLF score， Model for End-Stage Liver Disease （MELD） score， MELD combined with serum sodium concentration （MELD-Na） score， and MELD 3.0 score， and the two groups were compared in terms of basic clinical data， laboratory markers， complications， and the scores of each model. The chi-square test was used for comparison of categorical data between two groups， and the t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups. The receiver operating characteristic （ROC） curve was used to assess the performance of each score in predicting the prognosis of patients with comorbidity of HBV-ACLF and HE. Results The death group had a significantly higher age than the survival group （56.09±10.52 years vs 49.23±11.57 years， t=2.720， P=0.007）. Compared with the survival group， the death group had significantly higher incidence rate of complications （upper gastrointestinal bleeding and ascites） and laboratory markers （white blood cell count， neutrophil count， total bilirubin， international normalized ratio， serum creatinine， and blood urea nitrogen）（all P<0.05）. The death group had significantly higher COSSH-ACLF Ⅱ， COSSH-ACLF， MELD， MELD-Na， and MELD 3.0 scores than the survival group （all P<0.001）. The patients were stratified into low-， moderate-， and high-risk groups based on COSSH-ACLF Ⅱs score， and comparison between groups showed that the mortality rate of patients increased with the increase in COSSH-ACLF Ⅱ score （χ²=44.371， P<0.001）. The ROC curve analysis showed that COSSH-ACLF Ⅱ score had an area under the ROC curve （AUC） of 0.883 （95% confidence interval： 0.837‍ ‍—‍ ‍0.919） in predicting the 90-day mortality of patients with comorbidity of HBV-ACLF and HE， with a sensitivity of 90.5%， a specificity of 78.7%， and a predictive accuracy of 85.07% at the cut-off value of 7.25. COSSH-ACLF Ⅱ score had a better performance than COSSH-ACLF （AUC=0.841， P<0.05）， MELD 3.0 （AUC=0.733， P<0.05）， MELD-Na （AUC=0.723， P<0.05）， and MELD （AUC=0.716， P<0.05）. Conclusion COSSH-ACLF Ⅱ score can improve the accuracy of predicting 90-day prognosis in patients with comorbidity of HBV-ACLF and HE， and COSSH-ACLF Ⅱ risk stratification can help to simplify the grading of patients.
- Hepatitis B Virus,
- Acute-on-Chronic Liver Failure,
- Hepatic Encephalopathy,
- Prognosis

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References

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Value of Chinese Group on the Study of Severe Hepatitis B-acute-on-chronic liver failure Ⅱ score in predicting the short-term prognosis of patients with acute-on-chronic liver failure comorbid with hepatic encephalopathy

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