The Values Of KCH Criteria, CTP Scoring System,MELD Scoring System And MELD-Na Scoring System In Acute-on-chronic Liver Failure

Objectives:To evaluate and compare the values of KCH criteria, Child-Turcotte-Pugh scoring system, MELD scoring system and MELD-Na scoring system for acute-on-chronic liver failure.Methods:The values of KCH criteria, Child-Turcotte-Pugh scoring system, MELD scoring system and MELD-Na scoring system were evaluated using receiver operating characteristic curves (ROC). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under curve (AUC) were calculated basing on off-cut points.Results:Whether acute-on-chronic liver failure can be controlled is none of the business of KCH criteria (p>0.05). But the prognosis of acute-on-chronic liver failure is positively related to the value of CTP score, MELD score and MELD-Na score (P<0.01). The AUC values generated by the ROC curves for MELD and MELD-Na were higher than those of KCH criteria and CTP score (0.744,0.752,0.586,0.689 respectively). The sensitivity of CTP score is the highest (0.903), while its specificity is the lowest (0.419). Those of KCH criteria were opposite (0.334and0.839respectively).Conclusion:MELD scoring system and MELD-Na scoring system are the best models to predict the prognosis of acute-on-chronic liver failure. Using KCH criteria and CTP scoring system together can also get a good predictive value.