Predicting mortality for hepatorenal syndrome with liver‐specific scores
Alana Zulian Terres, Rafael Sartori Balbinot, Ana Laura Facco Muscope, Morgana Luisa Longen, Bruna Schena, Bruna Teston Cini, Gilberto Luis Rost, Juline Isabel Leichtweis Balensiefer, Louise Zanotto Eberhardt, Raul Ângelo Balbinot, Silvana Sartori Balbinot, Jonathan Soldera
Abstract
Background Hepatorenal syndrome (HRS) is a severe complication of cirrhosis which has a high mortality rate. The treatment for HRS is costly. Therefore, it is paramount to choose wisely the patients who could benefit from it. The purpose of this study is to analyse and compare the role of liver-specific scores when predicting mortality for HRS patients. Design and Setting Historical cohort study conducted in a public tertiary care teaching hospital. Methods Data from medical records from 2010 to 2016 were obtained by searching the hospital electronic database for every patient who received terlipressin. Every chart was reviewed in order to determine the diagnosis of cirrhosis and HRS. The data in these medical records were reviewed and multiple variables were collected. and included in 46 patients. Liver-specific scores were calculated and ROC-curves pairwise comparisons were performed using DeLong test. Results Child-Turcotte-Pugh (CTP) was able to predict mortality in 30-, 90- and 365 days, with AUROC of 0.76, 0.75 and 0.72 respectively. Values of CTP above 12 were able to predict higher mortality for all patients, with sensitivity of 38%, 36% and 30% and specificity of 100%, 100% and 100% for 30-, 90- and 365-day mortality, respectively (P < 0.05). CLIF-SOFA, CLIF-C ACLF, MELD and MELD-Na were inferior to CTP. Conclusion CTP score was superior to other liver-specific scores for predicting mortality in a cohort of cirrhotic patients complicated with HRS in a tertiary teaching hospital.