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

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

  • 0 min

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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.

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