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Evaluation of Prognostic Models for Mortality in Acute-on-Chronic Liver Failure: A Systematic Review and Critical Assessment

  • By

  • Tiantian Song

  • Jiaqi Zhao

  • Bei Jiang

  • Xinyang Wang

  • Zuokun Li

  • Qiuyun Pang

  • June 16, 2026

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  • 1

    ACLF is a severe syndrome with high mortality, necessitating accurate prognostic risk stratification for effective clinical decision-making.

  • 2

    A systematic review included 185 studies evaluating 75 prognostic models for ACLF, revealing a high risk of bias in most analyses.

  • 3

    Model discrimination varied, with c-statistics ranging from 0.58 to 0.84, and generally declined with longer prediction horizons.

  • 4

    ACLF-specific models, particularly CLIF-C ACLF, demonstrated better discrimination compared to general models, though further validation is needed.

  • 5

    Future research should focus on multicenter validation studies to enhance the evidence base for ACLF prognostic prediction models.

Original Source(s)

Prediction models for mortality in patients with acute on chronic liver failure: systematic review and critical appraisal

  • by Tiantian Song, Jiaqi Zhao, Bei Jiang, Xinyang Wang, Zuokun Li, Qiuyun Pang

  • June 16, 2026

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