Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study

doi:10.4254/wjh.v16.i5.809

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May 27, 2024 (publication date) through Jul 23, 2024

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Hepatol. May 27, 2024; 16(5): 809-821
Published online May 27, 2024. doi: 10.4254/wjh.v16.i5.809

Table 3 Characteristics of subtypes of acute-on-chronic liver failure, n (%)

Characteristic	Type A (n = 215)	Type B (n = 100)	Type C (n = 535)
Demographics
Sex, male	175 (81.4)	87 (87.0)	440 (82.2)
Age, yr [median (IQR)]	42.0 (34.0, 49.9)	46.9 (39.7, 54.2)^a	49.2 (43.0, 57.0)^b^,^c
Precipitating events
HBV reactivation	33 (15.3)	11 (11.0)	78 (14.6)
Bacterial infection	54 (25.1)	34 (34.0)	223 (41.7)^b
Alcohol intake	21 (9.77)	8 (8.00)	70 (13.1)
Superimposed hepatitis viruses	13 (6.05)	9 (9.00)	24 (4.49)
Portal vein thrombosis	0 (0.00)	2 (2.00)	4 (0.75)
Surgery	2 (0.93)	0 (0.00)	3 (0.56)
Drug use	29 (13.5)	6 (6.00)	59 (11.0)
Physiological exhaustion	19 (8.84)	7 (7.00)	30 (5.61)
Undefined	55 (25.6)	34 (34.0)	75 (14.0)^b^,^c
Complications
Hepatic encephalopathy
Non-overt HE	186 (86.5)	96 (96.0)	444 (83.0)
Grade I-II	20 (9.30)	3 (3.00)	71 (13.3)^b
Grade III-IV	9 (4.19)	1 (1.00)	20 (3.74)^b
Gastrointestinal bleeding	0 (0.00)	0 (0.00)	38 (7.10)^b^,^c
Ascites	69 (32.1)	10 (10.0)^a	436 (81.5)^b^,^c
Biochemical indicators [median (IQR)]
WBC (× 10⁹/L)	6.84 (5.27, 8.88)	6.23 (4.58, 8.67)	6.66 (4.64, 9.16)
HGB (g/L)	131 (118, 144)	126 (108, 136)^a	116 (98.0, 130)^b^,^c
PLT (× 10⁹/L)	121 (91.0, 154)	89.0 (62.0, 130)^a	80.0 (52.5, 116)^b^,^c
PT (s)	20.2 (2.35, 26.5)	22.5 (19.0, 27.6)^a	20.2 (2.52, 26.6)^b
INR	2.05 (1.72, 2.48)	2.08 (1.76, 2.50)	2.21 (1.81, 2.75)^c
ALT (IU/mL)	531 (200, 1131)	231 (90.7, 607)^a	133 (53.2, 388)^b^,^c
AST (IU/mL)	318 (170, 743)	230 (121, 482)^a	170 (91.0, 342)^b^,^c
AKP (IU/L)	152 (124, 198)	155 (120, 198)	146 (113, 186)
GGT (IU/L)	88.0 (57.0, 141)	82.0 (54.0, 132)	72.0 (43.0, 118)^c
TB (mg/dL)	19.2 (13.7, 25.8)	20.3 (14.2, 25.5)	20.7 (14.2, 28.5)^c
ALB (g/L)	32.1 (29.5, 35.2)	31.4 (28.4, 33.9)^a	29.9 (26.8, 33.1)^b^,^c
CRE (mg/L)	0.77 (0.61, 0.94)	0.75 (0.61, 0.94)	0.86 (0.68, 1.13)^b^,^c
BUN (mmol/L)	3.51 (2.87, 4.55)	3.92 (2.94, 6.05)^a	5.00 (3.65, 8.11)^b^,^c
Na (mmol/L)	137 (135, 140)	137 (133, 140)	136 (131, 138)^b^,^c
MELD score [median (IQR)]	19.9 (17.4, 24.1)	20.7 (17.9, 25.4)	22.6 (19.3, 26.8)^b^,^c
Mortality (LT free)
28-d	38 (17.7)	18 (18.0)	147 (27.5)^b^,^c
90-d	58 (27.0)	36 (36.0)	232 (43.4)^b^,^c

^aP < 0.05, type A vs type B acute-on-chronic liver failure (ACLF).

^bP < 0.05, type B vs type C ACLF.

^cP < 0.05, type A vs type C ACLF.

AoCLD: Acute-on-chronic liver disease; CHAE: Chronic hepatitis with acute exacerbation; LC-A: Liver cirrhosis active phase; LC-AD: Liver cirrhosis acute decompensation; ACLF: Acute-on-chronic liver failure; ALD: Alcohol-associated liver disease; MAFLD: Metabolic-associated fatty liver disease; DILI: Drug-induced liver injury; AILD: Autoimmune liver disease; MLD: Metabolic liver disease. LT: Liver transplantation; HE: Hepatic encephalopathy; IQR: Interquartile ranges; HGB: Hemoglobin; PLT: Platelet; PT: Prothrombin time; INR: International normalized ratio; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; AKP: Anterior Knee Pain; TB: Total bilirubin; ALB: Albumin; CRE: Creatinine; BUN: Blood urea nitrogen; MELD: Model for end-stage liver disease; WBC: White blood cell; GGT: γ-glutamyl transferase.

Citation: Zhang YY, Luo S, Li H, Sun SN, Wang XB, Zheng X, Huang Y, Li BL, Gao YH, Qian ZP, Liu F, Lu XB, Liu JP, Ren HT, Zheng YB, Yan HD, Deng GH, Qiao L, Zhang Y, Gu WY, Xiang XM, Zhou Y, Hou YX, Zhang Q, Xiong Y, Zou CC, Chen J, Huang ZB, Jiang XH, Qi TT, Chen YY, Gao N, Liu CY, Yuan W, Mei X, Li J, Li T, Zheng RJ, Zhou XY, Zhao J, Meng ZJ. Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study. World J Hepatol 2024; 16(5): 809-821
URL: https://www.wjgnet.com/1948-5182/full/v16/i5/809.htm
DOI: https://dx.doi.org/10.4254/wjh.v16.i5.809