Validity of prognostic scoring systems used in critically ill patients with acute on chronic liver failure

Methods Descriptive study of a cohort of patients admitted to ICU with a diagnosis of acutely decompensated liver cirrhosis between the years 2010-2013. Data collected included demographics, presence of comorbidities, severity of illness (APACHE II, SOFA, MELD and CLIFSOFA), etiology as well as cirrhosis stage, reason for admission, length of stay and mortality in ICU. Descriptive statistics were expressed as mean ± SD or median (interquartile range) for continuous variables and percentages for categorical data. The ability of the scoring systems to discriminate prognosis was assessed using the area under the receiver operating characteristic (AUROC) curve. Estimation of their calibration was established through the Hosmer-Lemeshow goodness of fit test. To evaluate the extent to which the scoring systems were valid for prediction of mortality the sensitivity (S), specificity (E), overall correctness of prediction, positive and negative predictive values (PPV, NPV) were all determined.