Predictive value of enzymatic liver function measured by LiMAx in patients with acute- and acute-on-chronic liver failure

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
M Büchter ◽  
P Manka ◽  
A Kahraman ◽  
G Gerken ◽  
A Katsounas
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Predictive Value ◽  
Chronic Liver ◽  
Chronic Liver Failure

Acute Liver Failure

2019 ◽  
pp. 264-269
Author(s):  
James Y. Findlay ◽  
Eelco F. M. Wijdicks
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Underlying Liver Disease ◽  
Rapid Deterioration ◽  
Uncommon Condition ◽  
Acute Insult

Acute liver failure (ALF) is an uncommon condition in which an acute insult results in a rapid deterioration of liver function, encephalopathy, and coagulopathy in the absence of prior underlying liver disease. It is differentiated from rapid deterioration in the setting of underlying liver disease (acute on chronic liver failure) and from the gradual deterioration in liver function that can occur in chronic liver failure.

Hepatic disorders

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Hepatic Encephalopathy ◽  
Liver Function ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Serum Bilirubin ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Chronic Liver ◽  
Bile Pigments ◽  
Chronic Liver Failure

Jaundice 348Acute liver failure 350Hepatic encephalopathy 352Chronic liver failure 354Abnormal liver function tests 356Jaundice (icterus) is the accumulation of bile pigments in serum and tissues including sclerae and skin. Jaundice is usually clinically detectable once serum bilirubin exceeds 50...

scholarly journals A novel predictive model based on inflammatory markers to assess the prognosis of patients with HBV-related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Li Qiang ◽  
Jiao Qin ◽  
Changfeng Sun ◽  
Yunjian Sheng ◽  
Wen Chen ◽  
...  
Keyword(s):  
Liver Failure ◽  
Predictive Value ◽  
Inflammatory Markers ◽  
Validation Cohort ◽  
Meld Score ◽  
Chronic Liver ◽  
Assessment Model ◽  
Operating Characteristics ◽  
Chronic Liver Failure ◽  
Distribution Width

Abstract Background Systemic inflammatory response is closely related to the development and prognosis of liver failure. This study aimed to establish a new model combing the inflammatory markers including neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) with several hematological testing indicators to assess the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods A derivation cohort with 421 patients and a validation cohort with 156 patients were recruited from three hospitals. Retrospectively collecting their clinical data and laboratory testing indicators. Medcalc-15.10 software was employed for data analyses. Results Multivariate analysis indicated that RDW, NLR, INR, TBIL and Cr were risk factors for 90-day mortality in patients with HBV-ACLF. The risk assessment model is COXRNTIC = 0.053 × RDW + 0.027 × NLR + 0.003 × TBIL+ 0.317 × INR + 0.003 × Cr (RNTIC) with a cut-off value of 3.08 (sensitivity: 77.89%, specificity: 86.04%). The area under the receiver operating characteristics curve (AUC) of the RNTIC was 0.873 [95% CI(0.837–0.903)], better than the predictive value of MELD score [0.732, 95% CI(0.687–0.774)], MELD-Na [0.714, 95% CI(0.668–0.757)], CTP[0.703, 95% CI(0.657–0.747)]. In the validation cohort, RNTIC also performed a better prediction value than MELD score, MELD-Na and CTP with the AUC of [0.845, 95% CI(0.778–0.898)], [0.768, 95% CI (0.694–0.832)], [0.759, 95% CI(0.684–0.824)] and [0.718, 95% CI(0.641–0.787)] respectively. Conclusions The inflammatory markers RDW and NLR could be used as independent predictors of 90-day mortality in patients with HBV-ACLF. Compared with MELD score, MELD-Na and CTP, RNTIC had a more powerful predictive value for prognosis of patients with HBV-ACLF.

scholarly journals A systematic review on prognostic indicators of acute on chronic liver failure and their predictive value for mortality

2012 ◽  
Vol 33 (1) ◽  
pp. 40-52 ◽  
Author(s):  
Kama A. Wlodzimirow ◽  
Saeid Eslami ◽  
Ameen Abu-Hanna ◽  
Martin Nieuwoudt ◽  
Robert A. F. M. Chamuleau
Keyword(s):  
Systematic Review ◽  
Liver Failure ◽  
Predictive Value ◽  
Chronic Liver ◽  
Prognostic Indicators ◽  
Chronic Liver Failure

scholarly journals Applicability and safety of discontinuous ADVanced Organ Support (ADVOS) in the treatment of patients with acute-on-chronic liver failure (ACLF) outside of intensive care

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249342
Author(s):  
L. Kaps ◽  
C. J. Ahlbrand ◽  
R. Gadban ◽  
M. Nagel ◽  
C. Labenz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Liver Function ◽  
Liver Failure ◽  
Alcoholic Cirrhosis ◽  
Observation Time ◽  
Chronic Liver ◽  
Water Soluble ◽  
Continuous Treatment ◽  
Organ Support ◽  
Chronic Liver Failure

Background ADVanced Organ Support (ADVOS) is a novel type of extracorporeal albumin dialysis and holds promise to sustain liver function and recovery of patients with acute-on-chronic liver failure (ACLF). Previously, ADVOS was tested as continuous treatment for intensive care patients with liver failure. Data related to the applicability and safety as discontinuous treatment outside of ICU is not available. Aim Evaluation of ADVOS as discontinuous treatment for patients with ACLF outside intensive care unit and comparison with a matched historic cohort. Methods and results In this retrospective study, 26 patients with ACLF and the indication for renal replacement therapy related to HRS-AKI were included. Majority of patients were male (65%) with alcoholic cirrhosis in 88% and infections as a trigger of ACLF in 96%. Liver function was severely compromised reflected by high median MELD and CLIF-C ACLF scores of 37 (IQR 32;40) and 56.5 (IQR 51;60), respectively. Patients were treated discontinuously with ADVOS over a median time of 12 days (IQR 8.25;17) and received 8 (IQR 4.25;9.75) treatment cycles on average. No treatment related adverse events were recorded, and safety laboratory parameters remained constant during the observation time. After 16 h cumulative dialysis therapy, ADVOS significantly reduced protein-bound bilirubin (14%), creatinine (11.8%) and blood urea nitrogen (BUN, 33%). Using a matched cohort with ACLF treated with hemodialysis, ADVOS achieved a stronger decrease in bilirubin (p = 0.01), while detoxification of water-soluble catabolites’ including creatinine and BUN was comparable. The 28-days mortality in the ADVOS group was 56% (14/26) and was not inferior to predicted survival (predicted median 28-days mortality was 44%, IQR 30; 59). Conclusion Discontinuous ADVOS treatment was safe and effective in patients with ACLF outside intensive care and outperformed hemodialysis in reducing protein-bound metabolites.

scholarly journals A novel predictive model based on inflammatory markers to assess the prognosis of patients with HBV-related acute-on-chronic liver failure: a retrospective cohort study

2019 ◽  
Author(s):  
Li Qiang ◽  
Jiao Qin ◽  
Changfeng Sun ◽  
Yunjian Sheng ◽  
Wen Chen ◽  
...  
Keyword(s):  
Liver Failure ◽  
Predictive Value ◽  
Inflammatory Markers ◽  
Validation Cohort ◽  
Meld Score ◽  
Chronic Liver ◽  
Assessment Model ◽  
Operating Characteristics ◽  
Chronic Liver Failure ◽  
Distribution Width

Abstract Backgrounds: Systemic inflammatory response is closely related to the development and prognosis of liver failure. This study aimed to establish a new model combing the inflammatory markers including neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) with several hematological testing indicators to assess the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods: A derivation cohort with 421 patients and a validation cohort with 156 patients were recruited from three hospitals. Retrospectively collecting their clinical data and laboratory testing indicators . Medcalc-15.10 software was employed for Data analyses.Results: Multivariate analysis indicated that RDW, NLR, INR, TBIL and Cr were risk factors for 90-day mortality in patients with HBV-ACLF. The risk assessment model is COX RNTIC =0.053× R DW+0.027× N LR+0.003× T BIL+0.317× I NR+0.003× C r (RNTIC) with a cut-off value of 3.082 (sensitivity: 77.89%, specificity: 86.04%). The area under the receiver operating characteristics curve (AUC) of the RNTIC was 0.873 [95%CI (0.837–0.903)], better than the predictive value of RDW [0.675, 95%CI (0.628–0.719)], NLR [0.693, 95%CI (0.646–0.737)] and MELD score [0.732, 95%CI (0.687–0.774)]. In the validation cohort, RNTIC also performed a better prediction value than RDW, NLR, and MELD score with the AUC of [0.845, 95%CI (0.778-0.898)], [0.670, 95%CI (0.591-0.744)], [0.732, 95%CI (0.655-0.799)] and [0.768, 95%CI (0.694-0.832)], respectively.Conclusions: The inflammatory markers RDW and NLR could be used as independent predictors of 90-day mortality in patients with HBV-ACLF. Compared with MELD score, RNTIC had a more powerful predictive value for prognosis of patients with HBV-ACLF.

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