A Novel Systemic Inflammation‐Based Model for Predicting Mortality in HBV‐Related ACLF

Excessive inflammation and immune activation are strongly associated with unfavorable outcomes and elevated mortality rates in hepatitis B virus (HBV)‐related acute‐on‐chronic liver failure (ACLF). However, the role of the C‐reactive protein to lymphocyte ratio (CLR) as a prognostic inflammatory biomarker in multiple diseases is rarely mentioned in HBV‐ACLF. This investigation aimed to assess the utility of the CLR and additional parameters in identifying high‐risk progression in HBV‐ACLF patients. A cohort of 639 hospitalized patients diagnosed with HBV‐ACLF based on the APASL criteria was divided into two cohorts: 447 cases in the training set and 192 cases in the validation set. Logistic regression analysis was employed to identify the XY‐model. The results of multiple factor analysis showed that the incidence of liver cirrhosis, age, CLR, serum total bilirubin, calcium, prothrombin activity, and alpha fetoprotein affect the prognosis of HBV‐ACLF. CLR emerged as a significant independent risk factor for disease progression in patients with ACLF (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01–1.04, p < 0.05). The novel model based on seven predictors could accurately predict short‐term mortality in patients with HBV‐ACLF, which is promising for guiding clinical management and addressing the etiological differences in Asian populations.