Abstract: Objective To investigate the predictive value of combined model for end-stage liver disease (MELD) score and serum procalcitonin (PCT) on the short-term prognosis in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). Methods A total of 331 HBV-related ACLF patients from January 2012 to December 2015 in our hospital were respectively analyzed, and divided into survival group (208 cases) and death group (123 cases) according to the prognosis by 3-month follow-up. Serum total bilirubin (TBil), creatinine (Cr), international normalized ratio (INR), serum PCT and MELD score were measured and compared between the two groups. The capability of MELD score combined with serum PCT was evaluated for predicting the short-term prognosis of HBV-related ACLF patients by receiver operating characteristic (ROC) curve. Results In death group, serum levels of TBIL (330.9±81.9 vs 245.5±67.7 μmol/L), Cr (94.9±23.8 vs 71.2±29.3 μmol/L), PCT (1.3±0.3 vs 0.5±0.2 μg/L), INR (2.5±1.0 vs 2.1±0.6) and MELD score (26.2±6.5 vs 22.0±5.8) were significantly higher than those in the survival group, while the serum level of Na+ (128.9±14.1 vs 133.8±9.3 mmol/L) was significantly lower (all P＜0.001). The optimal cut-off value of MELD score and serum level of PCT in predicting short-term mortality were 24.8 and 0.65 μg/L. The area under the ROC (AUC) of combined MELD score and PCT (0.880) was higher than that of only MELD score (0.820) or PCT (0.803), respectively (both P＜0.001). Conclusion MELD score combined with serum PCT achieves a predictive value for the short-term prognosis in patients with HBV-related ACLF.

Key words: Chronic hepatitis B, Acute-on-chronic liver failure, Prognosis, Model for end-stage liver disease, Procalcitonin