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Research Paper|Volume 9, Issue 1|pp 286—296

AKI-CLIF-SOFA: a novel prognostic score for critically ill cirrhotic patients with acute kidney injury

Dan-Qin Sun1, Chen-Fei Zheng2, Wen-Yue Liu3, Sven Van Poucke4, Zhi Mao5, Ke-Qing Shi6,7, Xiao-Dong Wang6,7, Ji-Dong Wang1, Ming-Hua Zheng6,7
  • 1Department of Nephrology, Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi 214002, China
  • 2Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • 3Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • 4Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
  • 5Department of Critical Care Medicine, Chinese People’s Liberation Army General Hospital, Beijing, China
  • 6Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • 7Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
Received: December 7, 2016Accepted: January 15, 2017Published: January 19, 2017
https://doi.org/10.18632/aging.101161

Copyright: © 2017 Sun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Critically ill cirrhotic patients with acute kidney injury (AKI) are associated with high mortality rates. The aims of this study were to develop a specific prognostic score for critically ill cirrhotic patients with AKI, the acute kidney injury - Chronic Liver Failure - Sequential Organ Failure- Assessment score (AKI-CLIF-SOFA) score. This study focused on 527 cirrhotic patients with AKI admitted to intensive care unit and constructed a new scoring system, the AKI-CLIF-SOFA, which can be used to prognostically assess mortality in these patient population. Parameters included in this model were analysed by cox regression. The area under the receiver operating characteristic curve (auROC) of AKI-CLIF-SOFA scoring system was 0.74 in 30 days, 0.74 in 90 days, 0.72 in 270 days and 0.72 in 365 days. Additionally, this study demonstrated that the new model had more discriminatory power than chronic liver failure- sequential organ failure assessment score (CLIF-SOFA), SOFA, model for end stage liver disease (MELD), kidney disease improving global outcomes (KDIGO) and simplified acute physiology score II (SAPS II) (auROC: 0.72, 0.66, 0.64, 0.62, 0.63 and 0.65 respectively, all P < 0.05) for the prediction of the 365-days mortality. Therefore, AKI-CLIF-SOFA demonstrated a valuable discriminative ability compared with KDIGO, CLIF-SOFA, MELD, SAPS II and SOFA in critically ill cirrhotic patients with AKI.