To investigate the value of prognostic nutrition index (PNI), antithrombin Ⅲ (AT-Ⅲ), and Chinese Group on the Study of Severe Hepatitis B-related acute-on-chronic liver failure score (COSSH-ACLFs) in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).

A retrospective analysis was proceeded for the clinical date of 277 patients with HBV-ACLF who were diagnosed and treated in the Nantong Third Affiliated Hospital of Nantong University from January 2016 to September 2021. According to the 90-day outcome after diagnosis, patients were divided into an improvement group with 108 patients and a deterioration group with 169 patients. The blood routine, hepatic biological indices, blood coagulation, grade of hepatic encephalopathy, mean arterial pressure, blood oxygen saturation, and oxygen flow within 24 hours after admission were recorded in patients with HBV-ACLF. Combined with ages, PNI, chronic liver failure consortium acute-on-chronic liver failure score, and COSSH-ACLFs were calculated. The receiver operating characteristic curve and the Logistic regression model were used to evaluate the value of PNI, AT-Ⅲ, and COSSH-ACLFs in predicting the 90-day prognosis of patients with HBV-ACLF.

Compared with the improvement group, the COSSH-ACLFs of patients with HBV-ACLF were significantly increased (Z = 11.189, P<0.001), and the levels of PNI and AT-Ⅲ were significantly decreased in the deterioration group (Z = 6.815, 6.000; both P<0.001). Multi-factorial Logistic regression analysis revealed that PNI [odds ratio (OR) = 0.886, 95% confidence interval (CI) (0.815, 0.963), P = 0.004], AT-Ⅲ [OR = 0.925, 95% CI (0.893, 0.958), P<0.001], and COSSH-ACLFs [OR = 11.456, 95%CI (5.700, 23.023), P<0.001] were independent risk factors for short-term prognosis of HBV-ACLF patients. The area under the curve (AUC) of PNI, AT-Ⅲ, and COSSH-ACLFs in predicting the short-term prognosis of HBV-ACLF patients was 0.737, 0.720, and 0.893 respectively. The combined prediction model had the best predictive efficiency, and the AUC could be achieved to 0.926.

The PNI, AT-Ⅲ, and COSSH-ACLFs have good value in evaluating short-term prognosis of patients with HBV-ACLF. Combining these indices has higher predictive value.