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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2021

01-12-2021 | Liver Transplantation | Research

Creatinine-lactate score predicts mortality in non-acetaminophen-induced acute liver failure in patients listed for liver transplantation

Authors: Estela Regina Ramos Figueira, Joel Avancini Rocha-Filho, Cinthia Lanchotte, Lucas Souto Nacif, Luciana Bertocco de Paiva Haddad, Adriana Rochetto Assalin, Yumi Ricucci Shinkado, Agustin Moscoso Vintimilla, Flavio Henrique Ferreira Galvao, Luiz Augusto Carneiro D’Albuquerque

Published in: BMC Gastroenterology | Issue 1/2021

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Abstract

Background

The aim of this study was to analyze prognostic indicators of in-hospital mortality among patients listed for urgent liver transplantation (LT) for non-acetaminophen (APAP)-induced acute liver failure (ALF).

Methods

ALF patients listed for LT according to the King’s College Criteria were retrospectively reviewed. Variables were recorded from medical records and electronic databases (HCMED and RedCap).

Results

The study included 100 patients, of which 69 were subject to LT and 31 died while waiting for LT. Patients were 35.5 ± 14.73 years old, and 78% were females. The main etiologies were virus (17%), drug-induced (32%), autoimmune (15%), and indeterminate hepatitis (31%). The prioritization-to-LT time interval was 1.5 days (0–9). The non-LT patients showed higher lactate (8.71 ± 5.36 vs. 4.48 ± 3.33 mmol/L), creatinine (229 ± 207 vs. 137 ± 136 µm/L), MELD (44 ± 8 vs. 38 ± 8), and BiLE scores (15.8 ± 5.5 vs. 10.3 ± 4.1) compared to LT patients (p < 0.05). Multiple logistic regression analysis identified creatinine and lactate as independent prognostic factors, and a creatinine-lactate (CL) score was developed. ROC analysis showed that creatinine, lactate, MELD, BiLE, and CL scores had considerable specificity (71–88%), but only BiLE, lactate, and CL presented high sensitivities (70%, 80%, and 87% respectively). AUCs were 0.696 for creatinine, 0.763 for lactate, 0.697 for MELD, 0.814 for BiLE, and 0.835 for CL.

Conclusions

CL and BiLE scores predict mortality with more accuracy than MELD in patients with ALF during prioritization time. Creatinine and lactate are independent prognostic factors for mortality.
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Metadata
Title
Creatinine-lactate score predicts mortality in non-acetaminophen-induced acute liver failure in patients listed for liver transplantation
Authors
Estela Regina Ramos Figueira
Joel Avancini Rocha-Filho
Cinthia Lanchotte
Lucas Souto Nacif
Luciana Bertocco de Paiva Haddad
Adriana Rochetto Assalin
Yumi Ricucci Shinkado
Agustin Moscoso Vintimilla
Flavio Henrique Ferreira Galvao
Luiz Augusto Carneiro D’Albuquerque
Publication date
01-12-2021

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