Background and aim: ACLF is a condition associated with high mortality. The CANONIC trial developed a score that classifies the ACLF grade according to the number of extrahepatic organic failures. Useful to determine prognosis of mortality with 33% ACLF-1, 35% ACLF-2 and 74% ACLF-3. Furthermore, it was identified that a score >70 at admission is associated with a 90% mortality in 90 days. That is why we consider it relevant to objectify the risk of mortality associated with the degree of complication in our population. Aim: To determine ACLF grade and CLIF-C score that predicts 28-day mortality in patients with chronic acute liver failure at the Juárez hospital in Mexico.
Material and methods: Retrospective descriptive observational study of patients diagnosed with ACLF according to the criteria of European and American associations, 2019 records were reviewed, severity was classified according to CLIF-C, survival curves were assessed using the Kaplan-Meier method and Cox Regression with the SPSS statistical program.
Results: In our study, 58 patients who met ACLF criteria were collected, of these 36.2% (n 21) ACLF-1, 39.7% (n 23) ACLF-2, 24.1% (n 14) ACLF-3. Survival curves were performed using the Kaplan-Meier method, reporting a 28-day survival of 25%, 18%, and 7.7%, respectively. It was compared between these without showing statistical significance (p=0.25). It was decided to carry out a multivariate analysis using the Cox regression method, analyzing the degree of ACLF, CLIF-C score, age, sex, infection, gastrointestinal bleeding, acute kidney injury (AKI), resulting among these that AKI is the only variable with significant association in survival (p=0.017).
Conclusions: In our population, it was identified that there is no significant statistical impact on survival between ACLF grades, nor the number of organic failures (Clif-C score). The presence of LRA proved to be a better independent predictor of mortality.
Conflicts of interest: The authors have no conflicts of interest to declare.