{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:40:00Z","timestamp":1781624400956,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T00:00:00Z","timestamp":1506384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Acute\u2010on\u2010chronic liver failure (ACLF) has characteristic feature of multisystem organ failure, rapid progression, and low early transplant\u2010free survival. We performed a meta\u2010analysis to determine the accuracy of five scoring systems in predicting mortality of ACLF patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic database search was performed, and retrieved articles were graded according to methodological quality. Collated data was meta\u2010analyzed by hierarchical summarized receiver operating characteristic model and bivariate model to evaluate the diagnostic accuracy of scoring systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 4223 studies identified, 26 studies involving 4732 ACLF patients were included. The model of end\u2010stage liver disease (MELD) score was found to have largest the area under summarized receiver operating characteristic (AUROC) (0.82) compared with other estimated scoring systems, especially for 3\u2010month mortality. MELD serum sodium (MELD\u2010Na) score showed homologous high accuracy, with the AUROC was 0.81. However, meta\u2010analyses of 16 studies showed that Child\u2013Pugh\u2013Turcotte score had least AUROC (0.71). Sequential organ failure assessment (SOFA) score presented moderately lower diagnostic accuracy, with AUROC being 0.73. Moreover, chronic liver failure\u2010SOFA score presented excellent accuracy of prognostication with highest diagnostic odds ratios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This review demonstrated that MELD had moderate diagnostic accuracy to predict mortality of ACLF patients. Considering the expectative diagnostic value, chronic liver failure\u2010SOFA could be regarded as a promising replacement of MELD. To improve the predictive power of scoring systems, multicenter prospective studies of large sample sizes with long\u2010term follow\u2010up are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13786","type":"journal-article","created":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T03:16:51Z","timestamp":1489720611000},"page":"1668-1678","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Performance of scoring systems to predict mortality of patients with acute\u2010on\u2010chronic liver failure: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"32","author":[{"given":"Yi\u2010Xiang","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Jun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue\u2010Gong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.41"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27077"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2012.02790.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.219"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.05.005"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00309-8"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-011-0228-2"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.10.006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2003.50016"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2013.28.8.1207"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20329"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.02.010"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0801209"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2005.00634.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.02.042"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-014-9580-2"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_6_19_1","first-page":"801","article-title":"Liver to abdominal area ratio in prognosis prediction in alcohol\u2010induced acute\u2010on\u2010chronic liver failure","volume":"96","author":"Chen J","year":"2016","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i40.14934"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12074"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001638"},{"key":"e_1_2_6_23_1","first-page":"2272","article-title":"Comparison of four prognostic models and a new Logistic regression model to predict short\u2010term prognosis of acute\u2010on\u2010chronic hepatitis B liver failure","volume":"125","author":"He WP","year":"2012","journal-title":"Chin. 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