Child-Pugh, MELD, and ALBI scores for predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure

Objectives: Our study aimed to evaluate the discriminative abilities of Child-Pugh, model for end-stage liver disease (MELD), and albumin-bilirubin (ALBI) scores in predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure (ACLF).Methods: Cirrhotic patients with ACLF admitted between 2010 January and 2014 June were retrospectively reviewed. Areas under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs) were calculated.Results: One hundred patients were eligible for the Asia-Pacific Association for the Study of the Liver (APASL) criteria. AUROCs of Child-Pugh, MELD, and ALBI scores in predicting the in-hospital mortality was 0.63 (95%CI: 0.52-0.72, P=0.05), 0.75 (95%CI: 0.65-0.83, P<0.0001), and 0.53 (95%CI: 0.42-0.63, P=0.69), respectively. Eighty-eight patients were eligible for the EASL/AASLD criteria. AUROCs of Child-Pugh, MELD, and ALBI scores in predicting the in-hospital mortality were 0.59 (95%CI: 0.48-0.69, P=0.14), 0.57 (95%CI: 0.46-0.68, P=0.26), and 0.57 (95%CI: 0.46-0.67, P=0.29), respectively. There was no significant difference among them.Conclusion: Child-Pugh, MELD, and ALBI scores might be ineffective in predicting the in-hospital mortality of cirrhosis with ACLF.