{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:13:43Z","timestamp":1791000823331,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81400589"],"award-info":[{"award-number":["81400589"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>HBV\u2010related acute\u2010on\u2010chronic liver failure (HBV\u2010ACLF) deteriorates rapidly in the short term, which necessitates accurate initial clinical decision making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To develop a novel prognostic score for patients with HBV\u2010ACLF and clarify the role of thyroid hormones in HBV\u2010ACLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort of 635 HBV\u2010ACLF patients was enrolled to develop and validate a novel prognostic score for HBV\u2010ACLF. Additionally, a cross\u2010sectional cohort (n\u00a0=\u00a0199) and a prospective longitudinal HBV\u2010ACLF cohort (n\u00a0=\u00a056) were recruited to clarify the association between thyroid hormone status and the 30\u2010day mortality of HBV\u2010ACLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HINT, a novel prognostic score based on hepatic encephalopathy, INR, neutrophil count, and thyroid\u2010stimulating hormone (TSH) using the deriving cohort (n\u00a0=\u00a0426), was significantly higher in non\u2010survivors than survivors (1.17\u00a0\u00b1\u00a02.38 vs \u22121.87\u00a0\u00b1\u00a01.26, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). The AUROC of HINT for 30\u2010day mortality was 0.889, which was significantly higher than that of the Child\u2010Pugh, MELD, CLIF\u2010SOFA, CLIF\u2010C ACLF, and COSSH\u2010ACLF scores (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). These results were confirmed in the validation cohort (n\u00a0=\u00a0209), except that the AUROC of HINT was comparable to that of COSSH\u2010ACLF (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.357). Among thyroid hormones, only the TSH level on admission was significantly lower in non\u2010survivors than in survivors (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). During the 14\u2010day longitudinal observation, TSH levels increased significantly in the improvement group (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) but did not change in the deterioration or fluctuation groups, and gradually increased in survivors (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) but not in non\u2010survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HINT, as a prognostic score for HBV\u2010ACLF, is simpler than and superior to the Child\u2010Pugh, MELD, CLIF\u2010SOFA, and CLIF\u2010C ACLF scores and at least comparable with the COSSH\u2010ACLF score. Sequential TSH measurements may facilitate prediction of the clinical course of ACLF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14927","type":"journal-article","created":{"date-parts":[[2018,8,3]],"date-time":"2018-08-03T13:12:36Z","timestamp":1533301956000},"page":"750-760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["HINT: a novel prognostic model for patients with hepatitis B virus\u2010related acute\u2010on\u2010chronic liver failure"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0337-4991","authenticated-orcid":false,"given":"Daxian","family":"Wu","sequence":"first","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases The First Affiliated Hospital College of Medicine Zhejiang University Hangzhou 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