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Background:As a large,prospective,multicenter study-based prognostic score for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF),the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score (COSSH-ACLFs),has been approved by some foreign scholars;however,its predictive value needs to be verified.This study investigated the predictive value of COSSH-ACLFs for short-term prognosis in Chinese patients with HBV-ACLF.Methods:This retrospective cohort study included 751 patients with HBV-ACLF admitted to the Fifth Medical Center of Chinese PLA General Hospital between January 2011 and December 2014.Spearman method was used to assess the correlation of COSSH-ACLFs with classical scores.Different COX multivariate regression models were used to confirm the relationship between COSSH-ACLFs and short-term prognosis in patients with HBV-ACLF,and stratified analysis was used to further verify the stability of this relationship.We compared the predictive powers of COSSH-ACLFs and other classical scores using area under the receiver operating characteristic curve (AUROC) and Z-test.Results:A total of 975 patients with HBV-ACLF were screened,and 751 were analyzed (623 male and 128 female).COSSH-ACLFs was the highest in patients with end-stage ACLF,followed by those with middle-and early-stage ACLF (H =211.8,P ＜ 0.001).In the fully adjusted model,COX multivariate regression analysis revealed that COSSH-ACLFs (as a continuous variable) was independently and positively correlated with mortality risk in patients with HBV-ACLF at 28 days (hazard ratio [HR]:1.37 [1.22,1.53],P ＜ 0.001) and 90 days (HR:1.43 [1.29,1.58],P ＜ 0.001).The same trend could be observed in the crude model and minimally adjusted model.The AUROCs of COSSH-ACLFs for 28-day and 90-day prognoses in patients with HBV-ACLF were 0.807 and 0.792,respectively,indicating a stronger predictive accuracy than those of classic models.Contusions:COSSH-ACLFs,with a superior predictive accuracy compared with other classical scores,can strongly predict shortterm prognosis in Chinese patients with HBV-ACLF.