Materiały źródłowe

• #1 Artificial intelligence-based evaluation of prognosis in cirrhosis | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05726-2

  Cirrhosis represents a significant global health challenge, characterized by high morbidity and mortality rates that severely impact human health. Timely and precise prognostic assessments of liver cirrhosis are crucial for improving patient outcomes and reducing mortality rates as they enable physicians to identify high-risk patients and implement early interventions. This paper features a thorough literature review on the prognostic assessment of liver cirrhosis, aiming to summarize and delineate the present status and constraints associated with the application of traditional prognostic tools in clinical settings. Among these tools, the ChildPugh and Model for End-Stage Liver Disease (MELD) scoring systems are predominantly utilized. However, their accuracy varies significantly. These systems are generally suitable for broad assessments but lack condition-specific applicability and fail to capture the risks associated with dynamic changes in patient conditions. Future research in this field is poised for deep exploration into the integration of artificial intelligence (AI) with routine clinical and multi-omics data in patients with cirrhosis. The goal is to transition from static, unimodal assessment models to dynamic, multimodal frameworks. Such advancements will not only improve the precision of prognostic tools but also facilitate personalized medicine approaches, potentially revolutionizing clinical outcomes.

• #2 Important predictor of mortality in patients with end-stage liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3701842/

  Prognosis is an essential part of the baseline assessment of any disease. For predicting prognosis of end-stage liver disease, many prognostic models were proposed. Child-Pugh score has been the reference for assessing the prognosis of cirrhosis for about three decades in end-stage liver disease. […] The MELD score has been an important role to accurately predict the severity of liver disease and effectively assess the risk of mortality. […] In recent large systematic review, the Child-Pugh score and MELD score were found to be predictive of death. […] Recent systemic review found the Child-Pugh score was still most significant among the predictors of death despite the absence of ascites, encephalopathy and jaundice in the patients with compensated cirrhosis, because its laboratory components, bilirubin, albumin and prothrombin time continued to be among the most frequent predictors, indicating that even subtle abnormalities in these laboratory parameters are predictive of death.

• #3 Important predictor of mortality in patients with end-stage liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3701842/

  Prognosis is an essential part of the baseline assessment of any disease. For predicting prognosis of end-stage liver disease, many prognostic models were proposed. Child-Pugh score has been the reference for assessing the prognosis of cirrhosis for about three decades in end-stage liver disease. […] The MELD score has been an important role to accurately predict the severity of liver disease and effectively assess the risk of mortality. […] In recent large systematic review, the Child-Pugh score and MELD score were found to be predictive of death. […] Recent systemic review found the Child-Pugh score was still most significant among the predictors of death despite the absence of ascites, encephalopathy and jaundice in the patients with compensated cirrhosis, because its laboratory components, bilirubin, albumin and prothrombin time continued to be among the most frequent predictors, indicating that even subtle abnormalities in these laboratory parameters are predictive of death.

• #4 Important predictor of mortality in patients with end-stage liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3701842/

  In recent years, MELD score emerged as a „modern” alternative to Child-Pugh score. […] The variables incorporated into the MELD score are simple and more objective. […] In addition to organ allocation, the MELD score has been an important contribution to hepatology given its ability to accurately gauge the severity of liver disease and effectively assess the risk of mortality.

• #5 Important predictor of mortality in patients with end-stage liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3701842/

  In addition to the Child-Pugh score, parameters that reflect a further deterioration of the circulatory status of the cirrhotic patient, such as parameters of renal dysfunction (creatinine and blood urea nitrogen) arise as powerful prognostic indicators in this setting and, therefore, it is not surprising that the MELD score (which incorporates creatinine in addition to markers of liver dysfunction) has become a valuable method to allocate organs. […] The MELD score, as an objective scale of disease severity, has been used in the management of patients with chronic liver disease in the non-transplant setting as below. […] In comparison with the CTP system, recent studies suggested that the MELD may more accurately predict the survival for patients with cirrhosis. […] The MELD score has also been shown to be a useful model in predicting the outcomes in cirrhotic patients undergoing major surgical procedures.

• #6 Important predictor of mortality in patients with end-stage liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3701842/

  In recent years, MELD score emerged as a „modern” alternative to Child-Pugh score. […] The variables incorporated into the MELD score are simple and more objective. […] In addition to organ allocation, the MELD score has been an important contribution to hepatology given its ability to accurately gauge the severity of liver disease and effectively assess the risk of mortality.

• #7 Core Concepts – Evaluation and Prognosis of Persons with Cirrhosis – Evaluation, Staging, and Monitoring of Chronic Hepatitis C – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-prognosis-cirrhosis/core-concept/all

  Prognosis and survival are markedly better in persons with compensated cirrhosis than in those with decompensated cirrhosis. […] The survival of persons with decompensated liver disease is significantly lower than in those with compensated disease. […] A MELD score should be calculated for all persons with decompensated cirrhosis to better estimate the survival probability and to determine eligibility for transplantation. […] The major goal of managing patients with HCV and compensated cirrhosis is to treat the HCV infection. […] Treatment of HCV in patients with compensated cirrhosis using direct-acting antiviral (DAA) medications has been associated with sustained virologic response (SVR) rates of 90% or better. […] For individuals with chronic HCV and decompensated cirrhosis who are liver transplantation candidates, successful treatment of HCV with DAA therapy has occurred before and after transplantation.

• #8 Core Concepts – Evaluation and Prognosis of Persons with Cirrhosis – Evaluation, Staging, and Monitoring of Chronic Hepatitis C – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-prognosis-cirrhosis/core-concept/all

  The development of ascites results in a significant drop in survival by 50% due to other life-threatening complications, such as hepatorenal syndrome or infections, that may ensue. […] Survival is poor in persons with decompensated cirrhosis, and they should be considered for liver transplantation.

• #9 Recent advances in the prevention and treatment of decompensated cirrhosis and acute-on-chronic liver failure (ACLF) and the role of biomarkers | Gut

  https://gut.bmj.com/content/73/6/1015

  The progression of cirrhosis with clinically significant portal hypertension towards decompensated cirrhosis remains clinically challenging and the evolution towards acute-on-chronic liver failure (ACLF), with one or more extrahepatic organ failures, is associated with very high mortality. […] The prognosis of decompensated patients also depends on the time of development of the decompensation. […] ACLF characterises the most aggressive form of AD and is determined by the development of hepatic and/or non-hepatic organ failures associated with a very high short-term mortality, as high as 20%80%, within 28 days. […] While the mechanisms driving the development of NAD/AD are shared, the stage of decompensation guides the standard of care, in particular due to the level and number of organ dysfunction.

• #10 Hepatic Encephalopathy and Spontaneous Bacterial Peritonitis Improve Cirrhosis Outcome Prediction: A Modified Seven-Stage Model as a Clinical Alternative to MELD

  https://www.mdpi.com/2075-4426/10/4/186

  Hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP) can be considered in a clinical perspective but no study has implemented a seven-stage classification and confirmed its value before. […] The addition of HE and SBP to the seven-stage model had a 5% better prediction result than the five-stage model did in the survival ROC analysis. […] The result showed that the seven clinical stages are associated with an increased risk for mortality. However, the predicted performances of the seven-stage model and MELD system are likely equivalent. […] The study proved that clinical staging of cirrhosis based on seven items/stages had higher prognostic value than the five-stage model and confirmed the validity of the MELD criteria vs. clinical assessment. […] The assessment of cirrhosis stages on the basis of simple clinical findings seems to be efficient, just like the New York Heart Association functional classes for patients with heart failure.

• #11 Hepatic Encephalopathy and Spontaneous Bacterial Peritonitis Improve Cirrhosis Outcome Prediction: A Modified Seven-Stage Model as a Clinical Alternative to MELD

  https://www.mdpi.com/2075-4426/10/4/186

  The advantages of the seven-stage model include raising patients’ awareness of their illness, patient–physician interactions, and educational programs. […] The study also confirmed the high prognostic validity of the MELD not only at three months, but also on a longer perspective in which it has been less validated and the optimal allocation strategy based on scoring systems is still under debate. […] The reasons why this seven-stage prognostic model was better than the five-stage model depend on the information nested in the occurrence of HE or SBP, which were not categorized in the five-stage model. […] Our study has proved that accurate clinical staging of cirrhosis based on seven stages has higher prognostic value than the five-stage model, and confirmed the validity of the MELD vs. clinical assessment.

• #12 Hepatic Encephalopathy and Spontaneous Bacterial Peritonitis Improve Cirrhosis Outcome Prediction: A Modified Seven-Stage Model as a Clinical Alternative to MELD

  https://www.mdpi.com/2075-4426/10/4/186

  The advantages of the seven-stage model include raising patients’ awareness of their illness, patient–physician interactions, and educational programs. […] The study also confirmed the high prognostic validity of the MELD not only at three months, but also on a longer perspective in which it has been less validated and the optimal allocation strategy based on scoring systems is still under debate. […] The reasons why this seven-stage prognostic model was better than the five-stage model depend on the information nested in the occurrence of HE or SBP, which were not categorized in the five-stage model. […] Our study has proved that accurate clinical staging of cirrhosis based on seven stages has higher prognostic value than the five-stage model, and confirmed the validity of the MELD vs. clinical assessment.

• #13 Prediction of long-term survival among patients with cirrhosis using time-varying models

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10241498/

  Risk prediction among patients with cirrhosis has historically focused on short-term (ie, 90 days) mortality among patients waitlisted for a transplant. […] Although several models have been developed to predict intermediate and longer term survivals, they have important limitations, namely, including only baseline laboratory and clinical variables to predict survival over a time horizon of years. […] Using data from a statewide sample of patients with cirrhosis, we developed and internally validated a time-updating model to predict survival with excellent discrimination. […] Based on its measures of discrimination (AUC and c-index), this model matched or exceeded the performance of other published risk models depending on the time horizon. […] If externally validated, this risk score could improve the care of patients with cirrhosis by improving counseling on intermediate and longer term outcomes to guide clinical decision-making and advanced care planning.

• #14 Dynamic risk prediction of survival in liver cirrhosis: A comparison of landmarking approaches | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0306328

  Dynamic risk prediction modeling is a vast research-scape and offers medical researchers a new paradigm for dealing with EHR data. […] The medical paradigm in which these DRP models will be assessed is the overall survival of patients with liver cirrhosis. Cirrhosis is a leading cause of mortality in the United States, implicated in the death of more than 50,000 patients each year, a number similar to diabetes and pneumonia and exceeding most cancers. […] The goal of this paper is to compare several different DRP modeling techniques based on the utilization of LM data sets. Specifically, we aim to compare the employment of PO or Cox regression for modeling survival outcomes for subjects diagnosed with liver cirrhosis. […] The dynamic model seems to be most advantageous when using the PM approach, and least advantageous when applying a Cox modeling procedure. Thus, determining what type of summary measure is desired when modeling should influence a researchers choice of modeling technique (dynamic or static) in a setting similar to ours. If a summary measure is desired in terms of survival duration, then a dynamic PM model might be best. Whereas, if the prediction is desired in terms of survival probability, and a standard Cox modeling procedure is desired, then a static model fit at baseline (such as SM2) might be a reasonable choice. […] The ultimate goal of dynamic risk prediction is to improve the accuracy of personalized prediction rules for individual patients.

• #15 Prognostic value of neutrophil count to albumin ratio in patients with decompensated cirrhosis | Scientific Reports

  https://www.nature.com/articles/s41598-023-44842-9

  NAR can be used as an independent predictor of poor outcomes for patients with DC during short-term follow-up. […] A total of 66 patients (10.6%) died within 90 days. […] The median NAR ratios were 0.76 (0.87) and 1.73 (2.28) for the survival and death groups, respectively (P0.001). […] The X-Tile software was used to classify patients into low-risk (NAR1.40) and high-risk (NAR1.40) groups with 90-day mortality rates of 5.11% (24/470) and 27.45% (42/153), respectively. […] Multivariate analysis demonstrated that NAR remained an independent factor of the 90-day outcome after adjustment for other confounders. […] We found that a higher NAR was associated with a higher risk of death for the primary outcome of 90-day mortality. […] The smoothing plot showed a clear relationship between NAR and 90-day mortality.

• #16 Prognostic value of neutrophil count to albumin ratio in patients with decompensated cirrhosis | Scientific Reports

  https://www.nature.com/articles/s41598-023-44842-9

  Our study aimed to investigate the prognostic value of neutrophil count to albumin ratio (NAR) in predicting short-term mortality of patients with decompensated cirrhosis (DC). […] NAR was significantly higher in 90-day non-survivors than in survivors (The median: 1.73 vs 0.76, P0.001). […] A threshold of 1.40 of NAR differentiated patients with a high risk of death (27.45%) from those with a low risk (5.11%). […] By multivariate analysis, high NAR was independently associated with poor short-term prognosis (high group: 5.07 (2.78, 9.22)). […] NAR alone had an area under the ROC curve of 0.794 and C-index of 0.7789 (0.7287, 0.8291) in predicting 90-day mortality. […] The integrated MELDNAR (iMELD) model had a higher area under the ROC (0.872) and C-index (0.8558 (0.8122, 0.8994)) than the original MELD in predicting 90-day mortality.

• #17 Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors

  https://www.mdpi.com/1648-9144/61/5/864

  Cirrhosis (OR = 1.69, 95% CI: 1.40–2.03) was a strong predictor of mortality […] The in-hospital mortality rate was significantly higher among those with cancer (60.7%), cirrhosis (65.95%), chronic kidney disease (62.1%), chronic obstructive pulmonary disease (63.2%), and pneumonia (67.8%) compared to those without these comorbidities. […] After adjusting for age, sex, receipt of surgery, and comorbidities in multivariate analysis, pneumonia and cirrhosis were the strongest predictors, indicating a more than twofold increased mortality risk (adjusted OR = 2.43, 95% CI: 2.19–2.69 and adjusted OR = 2.32, 95% CI: 1.90–2.85, respectively).

• #18 Pneumonia in patients with cirrhosis: risk factors associated with mortality and predictive value of prognostic models | Respiratory Research | Full Text

  https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-018-0934-5

  Cirrhosis always goes with profound immunity compromise, and makes those patients easily be the target of pneumonia. Cirrhotic patients with pneumonia have a dramatically increased mortality. To recognize the risk factors of mortality and to optimize stratification are critical for improving survival rate. […] Patients triggered acute-on-chronic liver failure (ACLF) highly increased mortality (46.4% vs 4.5% for 30-day, 69.6% vs 11.2% for 90-day). […] This study found age, bacteremia, WBC, total bilirubin and inappropriate empirical antibiotic therapy were independently associated with increased mortality. Pneumonia triggered ACLF remarkably increased mortality. CLIF-SOFA was more accurate in predicting mortality than other five prognostic models (model for end-stage liver disease (MELD), MELD-Na, quick sequential organ failure assessment (qSOFA), pneumonia severity index (PSI), Child-Turcotte-Pugh (CTP) score).

• #19 Pneumonia in patients with cirrhosis: risk factors associated with mortality and predictive value of prognostic models | Respiratory Research | Full Text

  https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-018-0934-5

  Cirrhosis always goes with profound immunity compromise, and makes those patients easily be the target of pneumonia. Cirrhotic patients with pneumonia have a dramatically increased mortality. To recognize the risk factors of mortality and to optimize stratification are critical for improving survival rate. […] Patients triggered acute-on-chronic liver failure (ACLF) highly increased mortality (46.4% vs 4.5% for 30-day, 69.6% vs 11.2% for 90-day). […] This study found age, bacteremia, WBC, total bilirubin and inappropriate empirical antibiotic therapy were independently associated with increased mortality. Pneumonia triggered ACLF remarkably increased mortality. CLIF-SOFA was more accurate in predicting mortality than other five prognostic models (model for end-stage liver disease (MELD), MELD-Na, quick sequential organ failure assessment (qSOFA), pneumonia severity index (PSI), Child-Turcotte-Pugh (CTP) score).

• #20 Pneumonia in patients with cirrhosis: risk factors associated with mortality and predictive value of prognostic models | Respiratory Research | Full Text

  https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-018-0934-5

  Cirrhotic patients with pneumonia were divided into ACLF and non-ACLF group and shown in Table 2. Sixty-nine patients (34.0%) were diagnosed ACLF according to EASL-CLIF definition. 30-day and 90-day mortality rate were 46.4 and 69.6% respectively. In contrast, patients without ACLF exhibited significantly lower mortality rate, 4.5 and 11.2% for 30-day and 90-day respectively. […] The factors that associated with 30- and 90-day mortality were listed in Additional file 2: Table S2. The factors may related to mortality were employed into univariate Cox regression analysis. After univariate analysis, the factors with statistical significance were entered in multivariate Cox regression analysis. […] Six prognostic models were tested for predicting 30-day and 90-day mortality in cirrhotic patients with pneumonia. […] CLIF-SOFA was more accurate in predicting 30-day and 90-day mortality for cirrhotic patients with pneumonia.

• #21 Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery | Frontline Gastroenterology

  https://fg.bmj.com/content/14/5/359

  As a result of the increasing incidence of cirrhosis in the UK, more patients with chronic liver disease are being considered for elective non-hepatic surgery. […] While this is true for those with decompensated cirrhosis, selected patients with compensated early-stage cirrhosis can have good outcomes after careful risk assessment. […] Clinical assessment supplemented by blood tests, imaging, liver stiffness measurement, endoscopy and assessment of portal pressure (derived from the hepatic venous pressure gradient) can facilitate risk stratification. […] Traditional prognostic scoring systems including the Child-Turcotte-Pugh and Model for End-stage Liver Disease are helpful but may overestimate surgical risk. […] Specific prognostic scores like Mayo Risk Score, VOCAL-Penn and ADOPT-LC can add precision to risk assessment.

• #22 Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery | Frontline Gastroenterology

  https://fg.bmj.com/content/14/5/359

  As a result of the increasing incidence of cirrhosis in the UK, more patients with chronic liver disease are being considered for elective non-hepatic surgery. […] While this is true for those with decompensated cirrhosis, selected patients with compensated early-stage cirrhosis can have good outcomes after careful risk assessment. […] Clinical assessment supplemented by blood tests, imaging, liver stiffness measurement, endoscopy and assessment of portal pressure (derived from the hepatic venous pressure gradient) can facilitate risk stratification. […] Traditional prognostic scoring systems including the Child-Turcotte-Pugh and Model for End-stage Liver Disease are helpful but may overestimate surgical risk. […] Specific prognostic scores like Mayo Risk Score, VOCAL-Penn and ADOPT-LC can add precision to risk assessment.

• #23 Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery | Frontline Gastroenterology

  https://fg.bmj.com/content/14/5/359

  The current bespoke prognostic scoring systems such as Mayo Risk Score, VOCAL-Penn and Adequate Operative Treatment for Liver Cirrhosis (ADOPT-LC) can be considered to aid multidisciplinary team decisions, in addition to CTP and Model for End-stage Liver Disease (MELD) score. […] Measuring HVPG can provide additional important information and may be considered as an adjunct to other prognostic parameters where available. […] However, further comparative multicentre studies are urgently needed, to guide selection of patients most likely to benefit.

• #24 Artificial intelligence-based evaluation of prognosis in cirrhosis | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05726-2

  The ChildPugh and MELD scoring systems are widely employed for prognostic evaluation in liver cirrhosis, encompassing four key biochemical markers, albumin level, INR, serum bilirubin level, and creatinine level, and two clinical diagnostics, ascites, and HE. […] Future research initiatives should prioritize further model validation and optimization to enhance generalizability and accuracy in multi-center and large-sample clinical validations. Moreover, efforts to amalgamate the strengths of diverse scoring systems to formulate a more comprehensive and precise prognostic metric are essential. […] The prognosis and mortality prediction in patients with cirrhosis are crucial for determining optimal timing of liver transplantation and other interventions. Traditional scoring systems like the ChildPugh and MELD have their predictive limitation due to the inclusion of subjective metrics, which may not accurately reflect the prognosis of individual patients, posing constraints in clinical applications. AI, however, has demonstrated great potential for enhancing mortality prediction in cirrhotic patients.

• #25 Artificial intelligence-based evaluation of prognosis in cirrhosis | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05726-2

  The ChildPugh and MELD scoring systems are widely employed for prognostic evaluation in liver cirrhosis, encompassing four key biochemical markers, albumin level, INR, serum bilirubin level, and creatinine level, and two clinical diagnostics, ascites, and HE. […] Future research initiatives should prioritize further model validation and optimization to enhance generalizability and accuracy in multi-center and large-sample clinical validations. Moreover, efforts to amalgamate the strengths of diverse scoring systems to formulate a more comprehensive and precise prognostic metric are essential. […] The prognosis and mortality prediction in patients with cirrhosis are crucial for determining optimal timing of liver transplantation and other interventions. Traditional scoring systems like the ChildPugh and MELD have their predictive limitation due to the inclusion of subjective metrics, which may not accurately reflect the prognosis of individual patients, posing constraints in clinical applications. AI, however, has demonstrated great potential for enhancing mortality prediction in cirrhotic patients.

• #26 Prediction of long-term survival among patients with cirrhosis using time-varying models

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10241498/

  Our model is not the first to focus on prediction of intermediate and longer term survival of patients with cirrhosis. […] However, there are key differences in this model that have attractive features as it relates to clinical practice. […] This information could help to inform advanced care planning, often not discussed in patients with cirrhosis, referral for transplant evaluation, and weighing decisions for nonliver-related care that may be impacted by a patients cirrhosis-related prognosis (eg, the aggressiveness of lung cancer therapy in a patient with early-stage lung cancer). […] In conclusion, by accounting for time-updating laboratory variables and clinical data, we were able to predict intermediate and longer term survival among patients with cirrhosis with excellent discrimination. […] If these models are externally validated, then this risk score could enhance the care of patients with cirrhosis by improving counseling on intermediate and longer term outcomes to guide clinical decision-making and advanced care planning.

• #27 Artificial intelligence-based evaluation of prognosis in cirrhosis | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05726-2

  The development and refinement of dependable tools for predicting the progression and outcomes of cirrhosis remain pivotal challenges in clinical research. This study aims to conduct a systematic review of the current global status of cirrhosis prognosis, the methodologies employed in prognostic evaluations, and recent advancements in prognostic approaches for cirrhosis. […] Prognosis assessment of patients with liver cirrhosis is a key part of clinical management and relies on a series of scoring systems such as the ChildPugh and MELD scores. A deeper understanding of the use and limitations of these assessment tools is the key and basis for accurately assessing patient prognosis, guiding clinical decision-making, and improving prognosis. […] The sharp drop in the survival rate of patients with decompensated cirrhosis highlights the need for accurate prognostic assessment and early intervention, which is crucial to improving long-term survival.

• #28 Artificial intelligence-based evaluation of prognosis in cirrhosis | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05726-2

  The ChildPugh and MELD scoring systems are widely employed for prognostic evaluation in liver cirrhosis, encompassing four key biochemical markers, albumin level, INR, serum bilirubin level, and creatinine level, and two clinical diagnostics, ascites, and HE. […] Future research initiatives should prioritize further model validation and optimization to enhance generalizability and accuracy in multi-center and large-sample clinical validations. Moreover, efforts to amalgamate the strengths of diverse scoring systems to formulate a more comprehensive and precise prognostic metric are essential. […] The prognosis and mortality prediction in patients with cirrhosis are crucial for determining optimal timing of liver transplantation and other interventions. Traditional scoring systems like the ChildPugh and MELD have their predictive limitation due to the inclusion of subjective metrics, which may not accurately reflect the prognosis of individual patients, posing constraints in clinical applications. AI, however, has demonstrated great potential for enhancing mortality prediction in cirrhotic patients.

• #29 Cirrhosis of the Liver Life Expectancy: Chart and Health Tips

  https://www.healthline.com/health/cirrhosis-of-the-liver-life-expectancy

  Cirrhosis is a chronic condition that can shorten someones life expectancy. […] Depending on how severe it is, cirrhosis can have an effect on life expectancy. […] The MELD system helps to determine the risk of death in people with end-stage liver disease. […] For someone with cirrhosis, a liver transplant can add years to their life expectancy. […] When talking about life expectancy, its important to remember that its an estimate. […] If you have cirrhosis, your doctor can give you a better idea of your outlook and what you can do to improve it.

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