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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Characteristics, Diagnosis and Prognosis of Acute-on-Chronic Liver Failure in Cirrhosis Associated to Hepatitis B
Scientific Reports, Volume 6, Article 25487, Year 2016
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Description
The diagnostic and prognostic criteria of acute-on-chronic liver failure (ACLF) were developed in patients with no Hepatitis B virus (HBV) cirrhosis (CANONIC study). The aims of this study were to evaluate whether the diagnostic (CLIF-C organ failure score; CLIF-C OFs) criteria can be used to classify patients; and the prognostic score (CLIF-C ACLF score) could be used to provide prognostic information in HBV cirrhotic patients with ACLF. 890 HBV associated cirrhotic patients with acute decompensation (AD) were enrolled. Using the CLIF-C OFs, 33.7% (300 patients) were diagnosed as ACLF. ACLF was more common in the younger patients and in those with no previous history of decompensation. The most common organ failures were 'hepatic' and 'coagulation'. As in the CANONIC study, 90-day mortality was extremely low in the non-ACLF patients compared with ACLF patients (4.6% vs 50%, p < 0.0001). ACLF grade and white cell count, were independent predictors of mortality. CLIF-C ACLFs accurately predicted short-term mortality, significantly better than the MELDs and a disease specific score generated for the HBV patients. Current study indicates that ACLF is a clinically and pathophysiology distinct even in HBV patients. Consequently, diagnostic criteria, prognostic scores and probably the management of ACLF should base on similar principles. © 2016, Nature Publishing Group. All rights reserved.
Authors & Co-Authors
Li, Hai
China, Shanghai
Shanghai Jiao Tong University
China, Beijing
Ministry of Health of People's Republic of China
Amorós, Àlex
Unknown Affiliation
Mookerjee, Rajeshwar Prosad
United Kingdom, London
University College London
Xie, Qing
China, Shanghai
Shanghai Jiao Tong University
Foster, Graham R.
United Kingdom, London
Queen Mary University of London
Dusheiko, Geoffrey M.
United Kingdom, London
University College London
Moreau, Richard
France, Clichy
Hôpital Beaujon
Arroyo, Vicente
Spain, Barcelona
Hospital Clinic Barcelona
Jalan, Rajiv
United Kingdom, London
University College London
Statistics
Citations: 129
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1038/srep25487
ISSN:
20452322
Research Areas
Infectious Diseases