{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:12:48Z","timestamp":1747185168262,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"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":["82000601"],"award-info":[{"award-number":["82000601"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To weight the prognostic value of thyroid hormones in catastrophic acute\u2010on\u2010chronic liver failure (ACLF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a0635) and two prospective cohorts (<jats:italic>n<\/jats:italic>\u00a0=\u00a0353, and 198) were enrolled in this study. The performance of a novel developed prognostic score was assessed from aspects of reliability, discrimination, and clinical net benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thyroid\u2010stimulating hormone (TSH) was identified to have the most potential as a prognostic predictor for hepatitis B virus\u2010related ACLF among thyroid hormones. The novel score (modified chronic liver failure\u2013organ failure score [mCLIF\u2010OFs]) was developed with weighted TSH and other scored organs in the CLIF\u2010OFs using the retrospective cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a0635). The predicted risk and observed probabilities of death were comparable across the deciles of mCLIF\u2010OFs (Hosmer\u2013Lemeshow \u03c7<jats:sup>2<\/jats:sup>\u00a0=\u00a04.28, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.83; Brier scaled\u00a0=\u00a011.9). The C\u2010index of mCLIF\u2010OFs (0.885 [0.883\u20130.887]) for 30\u2010day mortality was significantly higher than that of the CLIF\u2010OFs, chronic liver failure\u2013sequential organ failure assessment score (CLIF\u2010SOFAs), CLIF\u2010C ACLFs, Model of End\u2010stage Liver Disease (MELD), and Child\u2013Pugh (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The absolute improvements of prediction error rates of the mCLIF\u2010OFs compared to the above five scores were from 19.0% to 61.1%. After the analysis of probability density function, the mCLIF\u2010OFs showed the least overlapping coefficients (27.9%) among the above prognostic scores. Additionally, the mCLIF\u2010OFs showed greater net benefit than the above five prognostic scores over a wide range of risk threshold of death. Similar results were validated in two prospective ACLF cohorts with HBV and non\u2010HBV etiologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Weighted TSH portended the outcome of ACLF patients, which could be treated as a \u201cdamaged organ\u201d of the hypothalamic\u2013pituitary\u2013thyroid axis. The novel mCLIF\u2010OFs is a reliable prognostic score with better discrimination power and clinical net benefit than CLIF\u2010OFs, CLIF\u2010SOFAs, CLIF\u2010C ACLFs, MELD, and Child\u2013Pugh.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13970","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T17:17:54Z","timestamp":1695921474000},"page":"151-161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Weighted thyroid\u2010stimulating hormone disturbance in prognosis of hepatitis B virus\u2010related acute\u2010on\u2010chronic liver failure"],"prefix":"10.1111","volume":"54","author":[{"given":"Yasi","family":"Tu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Jiangxi Medical Center for Critical Public Health Events the First Affiliated Hospital, Nanchang University  Nanchang 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