Objective      To establish a new prognostic model of 3-month mortality in patients with acute liver fa

ilure (ALF) and compare the values of our new model with the model for end-stage liver disease (MELD)

MELD with incorporation of sodium (MELD-Na)

integrated MELD (IMELD) and United Kingdom model for end-stage liver disease (UKELD) in predicting the prognosis of ALF.       Methods      In a retrospective case-control study

234 patients with ALF hospitalized in our institute from January 2000 to December 2012 were retrospectively recruited in the study

and divided into 2 groups according to their prognosis

that is

the survival and the dead. Their laboratory parameters and complications were compared. SPSS 19.0 software was used for statistical analysis. Multivariate logistic regression analysis was used to establish the model. The predictive accuracy of models was compared using the area under the receiver operating characteristic (ROC) curve.       Results      The 3-month mortality in ALF was 76.50%. The factors predicting prognosis were total bilirubin (TB

OR=1.077

95%CI=1.028~1.130

P=0.002)

international normalized ratio (INR

OR=2.555

95%CI=1.561~4.182

P=0.000)

serum Na

+

(OR=0.938

95%CI=0.883~0.996

P=0.037)

ascites (OR=2.804

95%CI=1.140~6.892

P=0.025) and infections (OR=5.348

95%CI=2.268~12.610

P=0.000) when the indexes reached the criterion of ALF on admission. Our short-term prognosis model for ALF (MALF) is: P=1/[1+exp(-y)

]

y= 4.448+0.074×TB+0.938×INR-0.064×Na

+

+1．031×Ascites+1.677×Infections. MALF had a sensitivity of 98.03% and a specificity of 97.26%. MALF had a higher value of AUC (0.952

95%CI=0.907~0.997)

when compared to MELD (0.783

95%CI=0.720~0.845)

MELD-Na (0.825

95%CI=0.762~0.887)

IMELD (0.793

95%CI=0.726~0.860)

and UKELD (0.841

95%CI=0.781~0.901)

and their differences were all statistically significant (P0.001).       Conclusion      Our established prognostic model of ALF has superior sensitivity and specificity. It is of good clinical value

and superior to the MELD

MELD-Na

IMELD and UKELD scores in prediction of short-term prognosis of ALF.