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Title: Characteristics, Diagnosis and Prognosis of Acute-on-Chronic Liver Failure in Cirrhosis Associated to Hepatitis B
Author: Li, Hai
Chen, Liu-Ying
Zhang, Nan-nan
Li, Shu-Ting
Zeng, Bo
Pavesi, Marco
Amorós, Àlex
Mookerjee, Rajeshwar P.
Xia, Qian
Xue, Feng
Ma, Xiong
Hua, Jing
Qiu, De-kai
Xie, Qing
Foster, Graham R
Dusheiko, Geoffrey
Moreau, Richard
Ginès i Gibert, Pere
Arroyo, Vicente
Jalan, Rajiv
Sheng, Li
Keywords: Cirrosi hepàtica
Hepatitis B
Malalties del fetge
Hepatic cirrhosis
Hepatitis B
Liver diseases
Issue Date: 5-May-2016
Publisher: Nature Publishing Group
Abstract: 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.
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It is part of: Scientific Reports, 2016, vol. 6, p. 25487
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ISSN: 2045-2322
Appears in Collections:Articles publicats en revistes (Medicina)

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