Survival of Patients with Alcohol-Related Liver Disease Cirrhosis - Usefulness of the New LIV-IN Prognostic Score

Background/Objectives: Alcohol can directly damage the liver, causing steatosis, steatohepatitis, cirrhosis, and hepatocellular cancer. The aim of this study was to examine 28-day survival in hospitalized patients with alcohol-related liver disease (ALD) cirrhosis, as well as to develop and validate a new survival prediction model. Methods: A total of 145 patients with ALD cirrhosis were included, 107 were diagnosed with acute decompensation (AD) and 38 with acute-on-chronic liver failure (ACLF). The new LIV-IN (LIVer mortality INpatients) score was calculated using the following variables: hepatic encephalopathy (HE), hepatorenal syndrome (HRS), ascites, systemic inflammatory response syndrome (SIRS), community-acquired infection (CAI), and fibrinogen. The diagnostic accuracy of the LIV-IN score, as well as Model for end-stage liver disease (MELD), Model for end-stage liver disease-Sodium (MELD-Na), albumin-bilirubin (ALBI), Neutrophil-to-lymphocyte ratio (NLR), Chronic Liver Failure Consortium-C acute decompensation (CLIF-C AD), Chronic Liver Failure Consortium- acute-on-chronic liver failure (CLIF-C ACLF) was tested. Results: Lethal outcome occurred in 46 (31.7%) patients. The mortality rate was higher in the ACLF group (n=22, 57.9%) compared to the AD group (n=24, 22.4%) (p<0.01). The highest predictive power for short-term mortality was observed for the LIV-IN score (AUC 73.4%, p<0.01). In patients with AD, the diagnostic accuracy of the CLIF-C AD score was better than for the LIV-IN score (AUC 0.699; p=0.004, AUC 0.686; p=0.007, respectively). In patients with ACLF, only the LIV-IN score had statistically significant discriminative power in predicting 28-day survival. Conclusion: LIVer mortality Inpatients prognostic score is a new, reliable prognostic model in predicting 28-day mortality.