Objective Application of bilirubin and international standardized ratio to predict the timing of liver transplan-tation in autoimmune hepatitis(AIH).Methods This was a retrospective cohort study conducted in our hospital from January 2018 to October 2022,and 52 AIH patients were selected as the research objects.The baseline international normalized ratio(INR),the change of INR and the change of total bilirubin within 3 days after starting corticosteroid treatment were recorded on the first day(D0)and the third day(D3)to calculate the SURFASA score.The performance of SURFASA in predicting the re-sponse to corticosteroid therapy was evaluated by the area under the operator characteristic curve(AUC)of subjects.Results Of the 52 patients,38(73.1%)responded to corticosteroids,10(19.2%)received liver transplantation,and 4(7.7%)died of infectious complications.SURFASA score of respondents[-4.40(-4.82,-3.82)]was significantly lower than that of non-responders[-1.83(-2.37,-1.84)].INR(D3)[OR=6.85;95%CI 2.23-7.06;P<0.001)]and SURFASA[OR=6.97;95%CI 1.59-30.46;P<0.001)]was independently related to corticosteroid unresponsiveness.SURFASA score(AUC=0.96,95%CI 0.92-1.00)had excellent performance in predicting treatment response.The sensitivity,specificity,PPV and NPV of excluding corticoster-oid response with a score higher than-2.6 were 85.7%,100%,100%and 95%,respectively.Conclusions SURFASA score has the highest AUC in early identification of unresponsiveness to corticosteroids in patients with AIH,indicating that it may be a valuable tool for rapid evaluation of liver transplantation.
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