scholarly journals Validation of prognostic scores to predict short-term mortality in patients with HBV-related acute-on-chronic liver failure

Medicine ◽  
2017 ◽  
Vol 96 (17) ◽  
pp. e6802 ◽  
Author(s):  
Ning Li ◽  
Chong Huang ◽  
Kang-Kang Yu ◽  
Qing Lu ◽  
Guang-Feng Shi ◽  
...  
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Prognostic Scores ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

scholarly journals Evaluation of treatment outcome in patients with acute-on-chronic liver failure using clinical scores

2020 ◽  
Vol 148 (3-4) ◽  
pp. 153-159
Author(s):  
Tamara Milovanovic ◽  
Milica Stojkovic-Lalosevic ◽  
Sanja Dragasevic ◽  
Nevena Jocic ◽  
Marko Baralic ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Failure ◽  
High Mortality ◽  
Chronic Liver ◽  
Apache Ii ◽  
Prognostic Scores ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality ◽  
Precise Prediction

Introduction/Objective. Due to a very high mortality risk, acute-on-chronic liver failure (ACLF) patients require early identification and intensive treatment. Precise prediction is crucial for determining the urgency degree and therapy appropriateness, considering high mortality and multitude of clinical resources. The aim of our study was to determine the exact cut-off values of various prognostic scores in the prediction of morality of ACLF. Methods. This prospective study includes chronic liver disease (CLD) patients, admitted due to decompensation, that were subsequently diagnosed with ACLF at the Emergency unit. All patients were evaluated based on various prognostic scores, including Child?Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C, which were calculated on admission. Results. Alcoholic liver disease (ALD) was the most common underlying CLD cause (77.9%), followed by viral (8.6%), autoimmune (7.7%), and other causes (5.8%). A total of 37.5% of the patients died at the end of the first month of treatment. Average values of Child?Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C scores were significantly higher in patients who died compared to survivors (p < 0.05). CLIF C score showed the best performance with a cut-off value of 50.5, with a sensitivity of 94.9% and specificity of 40%. Conclusion. ACLF remains a condition with a high short-term mortality. Of all of the scores examined in our study, CLIF C proved to be the best scoring system for predicting short term and end of treatment mortality in patients with ACLF.

scholarly journals Acute on chronic liver failure- etiology, clinical profile, prognostic scores: experience from tertiary care centre of eastern India

2021 ◽  
Vol 9 (11) ◽  
pp. 3405
Author(s):  
Sanatan Behera ◽  
Vivek Prakash ◽  
Shivam Bajpai ◽  
Umesh Chandra Patra ◽  
Sushanta Kumar Jena
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Liver Failure ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Prognostic Scores ◽  
Eastern India ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

Background: Acute on chronic liver failure (ACLF) is a recently recognised entity in chronic liver disease patients. Data regarding ACLF in terms of clinical presentation, etiology of underlying cirrhosis, precipitating factors, prognostic factors are lacking from eastern India. The present study was undertaken to evaluate the above factors along with the assessment of short-term mortality (4 weeks) in patients of ACLF.Methods: In this prospective observational study, 120 patients diagnosed as ACLF were included. A comparison of complications, biochemical profiles and prognostic scores was made between the survivor and non-survivor groups.Results: Of the 120 ACLF patients included, the mean age was 44.9±8.6 years and the male to female ratio was 2.5:1. Common clinical presentations were jaundice (100%), ascites (88.3%), hepatic encephalopathy (60%). The most common etiology for underlying CLD was alcohol (51.7%) followed by chronic hepatitis B (20%) and chronic hepatitis C (15%) infection. Alcohol hepatitis (40%) followed by hepatotropic viral infections (20%) and drug-induced liver injury (15%) were common identifiable precipitating agents. After a follow-up period of 4 weeks, 56 (46.6%) out of 120 patients died. The presence of sepsis, hyponatremia, renal failure, and coagulopathy was significantly associated with high mortality. Mortality was higher among patients having high Chronic liver failure consortium- acute on chronic liver failure (CLIF-ACLF) grade and closely related to the number of organ failures.Conclusions: ACLF is a rapidly progressive syndrome in chronic liver disease patients, having high short-term mortality.

Validation of prognostic scores to predict short-term mortality in patients with acute-on-chronic liver failure

2018 ◽  
Vol 33 (4) ◽  
pp. 900-909 ◽  
Author(s):  
Do Seon Song ◽  
Tae Yeob Kim ◽  
Dong Joon Kim ◽  
Hee Yeon Kim ◽  
Dong Hyun Sinn ◽  
...  
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Prognostic Scores ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

Clinical Features of Hepatitis C Virus-Related Acute-On-Chronic Liver Failure in a Korean Population

2021 ◽  
Author(s):  
Jung Woo Choi ◽  
Jin-Kyu Cho ◽  
Sang Soo Lee ◽  
Jae Heon Kim ◽  
Hankyu Jeon ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus ◽  
Short Term Mortality ◽  
Very High

Abstract Background Acute-on-chronic liver failure (ACLF) is a widely recognized concept in which acute decompensation (AD) in patients with cirrhosis results in organ failures and high short-term mortality. However, few studies reflecting the various etiologies of cirrhosis are available. We aimed to investigate the clinical features of patients with hepatitis C virus (HCV)-related ACLF. Methods Between January 2005 and December 2018, 109 HCV-related cirrhosis patients who were hospitalized for AD (ascites, hepatic encephalopathy, gastrointestinal hemorrhage, and/or bacterial infection) were enrolled for ACLF defined by European Association for the Study of the Liver (EASL). Results ACLF developed in 35 patients (32.1%) on admission. Eight patients had ACLF grade 1, eight had ACLF grade 2, and 19 had ACLF grade 3. The 28-day and 90-day mortality rates were very low (2.7% and 5.4%, respectively) in patients without ACLF and very high (60.0% and 74.3%, respectively) in those with ACLF. In patients with HCV-related ACLF, the prevalence of liver failure was very low (17.1%), whereas that of kidney failure was very high (71.4%) compared to previous studies on hepatitis B virus-related ACLF and alcohol-related ACLF. Compared with all other prognostic scores, Chronic liver failure Consortium Organ Failure score most accurately predicted 90-day mortality, with an area under the receiver operator characteristic of 0.921. Conclusions HCV-related ACLF has unique clinical characteristics that are distinct from hepatitis B virus-related and alcohol-related ACLF. ACLF defined by EASL can be useful in predicting short-term mortality in HCV-related cirrhosis.

APACHE II score is superior to SOFA, CTP and MELD in predicting the short-term mortality in patients with acute-on-chronic liver failure (ACLF)

2013 ◽  
Vol 14 (9) ◽  
pp. 484-490 ◽  
Author(s):  
Ajay Duseja ◽  
Narendra S Choudhary ◽  
Sachin Gupta ◽  
Radha Krishan Dhiman ◽  
Yogesh Chawla
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

scholarly journals Bilirubin alone as a biomarker for short-term mortality in acute-on-chronic liver failure: an important prognostic indicator

2014 ◽  
Vol 13 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Jorge A. López-Velázquez ◽  
Norberto C. Chávez-Tapia ◽  
Guadalupe Ponciano-Rodríguez ◽  
Vicente Sánchez-Valle ◽  
Stephen H. Caldwell ◽  
...  
Keyword(s):  
Liver Failure ◽  
Prognostic Indicator ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

scholarly journals Comparing CLIF-C ACLF, CLIF-C ACLFlactate, and CLIF-C ACLF-D Prognostic Scores in Acute-on-Chronic Liver Failure Patients by a Single-Center ICU Experience

2021 ◽  
Vol 11 (2) ◽  
pp. 79
Author(s):  
Chao-Cheng Kuo ◽  
Chien-Hao Huang ◽  
Ching Chang ◽  
Pin-Cheng Chen ◽  
Bo-Huan Chen ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Failure ◽  
Characteristic Curve ◽  
Chronic Liver ◽  
High Rate ◽  
Prognostic Scores ◽  
Chang Gung Memorial Hospital ◽  
Chronic Liver Failure ◽  
Short Term Mortality ◽  
Overall Mortality

Patients with liver cirrhosis have a higher risk of developing acute-on-chronic liver failure (ACLF). Poor prognosis with a high rate of short-term mortality leads to limited opportunities for further liver transplantation. Thus, precise prognostic evaluation of patients with ACLF is necessary before transplant surgery. In this study, a total of one hundred and thirty-five patients with ACLF admitted to the hepato-gastroenterologic intensive care unit (ICU) for intensive monitoring and treatment at Chang-Gung Memorial Hospital (CGMH, Linkou, Taiwan) were screened from November 2012 to April 2015 and tracked until April 2017. Three new prognostic scores of ACLF, including CLIF-C ACLF (Chronic Liver Failure Consortium Acute-on-chronic Liver Failure score), CLIF-C ACLF-D (CLIF-C ACLF Development score), and CLLF-C ACLFlactate (lactate-adjusted CLIF-C ACLF score) were compared. The primary outcome considered was overall mortality. Mortality predictions at 28, 90, 180, and 365 days were also calculated. By area under the receiver operating characteristic curve (AUROC) analysis, the CLIF-C ACLF and CLIF-C ACLF-D scores were superior to CLIF-C ACLFlactate scores in predicting 28-day mortality. The CLIF-C ACLF-D score had the highest AUROC in predicting overall mortality as well as at 90, 180, and 365 days. In conclusion, our study demonstrates that CLIF-C ACLF and CLIF-C ACLF-D scores are significant predictors of outcome in critical patients with liver cirrhosis and ACLF. The CLIF-C ACLF-D score may have a superior predictive power for the prediction of 3-month, 6-month, and one-year mortality.

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