Acute-on-chronic liver failure in a multi-ethnic Asian city: A comparison of patients identified by Asia-Pacific Association for the Study of the Liver and European Association for the Study of the Liver definitions

Table 1 Profile of patients with acute-on-chronic liver failure n (%)

	APASL only (n = 14)	EASL only (n = 15)	Both (n = 49)	P value3	Total (n = 78)
AGE (mean)	53 (48-57)	66 (61-71)	57 (54-60)	0.003	58 (55-61)
Race
Chinese	9 (64.3)	9 (60)	36 (73.5)	0.171	54 (69.2)
Malay	1 (7.1)	2 (13.3)	5 (10.2)		8 (10.3)
Indian	0	3 (20)	5 (10.2)		8 (10.3)
Others	4 (28.6)	1 (6.7)	3 (6.1)		8 (10.3)
Male gender	12 (85.7)	11 (73.3)	36 (73.5)	0.625	59 (75.6)
Diabetes mellitus	7 (50)	5 (33.3)	16 (32.7)	0.478	28 (35.9)
Cause of acute liver injury4
Infection	4 (28.6)	14 (93.3)	28 (57.1)	0.002	46 (59)
Hepatitis B flare	9 (64.3)	0	14 (28.6)	0.001	23 (29.5)
Variceal bleeding	4 (28.6)	2 (13.3)	13 (26.5)	0.535	19 (24.4)
Unknown cause	2 (14.3)	1 (6.7)	8 (16.3)	0.642	11 (14.1)
Alcohol	1 (7.1)	0	5 (10.2)	0.429	6 (7.7)
TCM	1 (7.1)	0	5 (10.2)	0.429	6 (7.7)
TIPSS	0	0	1 (2)	0.741	1 (1.3)
Underlying chronic liver disease
Hepatitis B	11 (78.6)	1 (6.7)	22 (44.9)	< 0.0001	34 (43.6)
Alcohol	2 (14.3)	3 (20)	11 (22.4)	0.799	16 (20.5)
Cryptogenic	0	3 (20)	6 (12.2)	0.234	9 (11.5)
Hepatitis C	0	2 (13.3)	3 (6.1)	0.339	5 (6.4)
NASH	0	2 (13.3)	2 (4.1)	0.23	4 (5.1)
Hepatitis B + alcohol	1 (7.1)	0	1 (2)	0.444	2 (2.6)
Others1	0	4 (26.7)	5 (10.2)	0.072	9 (11.5)
Liver cirrhosis	6 (42.9)	15 (100)	49 (100)	< 0.0001	70 (89.7)
HCC (Milan’s criteria)	0	1 (6.7)	4 (8.2)	0.627	5 (6.4)
Other cancers2	0	1 (6.7)	4 (8.2)		5 (6.4)
No malignancy	14 (100)	13 (86.7)	41 (83.7)		68 (87.2)
Previous decompensation	4 (28.6)	10 (66.7)	20 (43.5)	0.11	34 (45.3)

¹Other chronic liver diseases include Wilson's disease, Primary Sclerosing Cholangitis, Primary Biliary Cirrhosis, Congenital fibrosis, Drug-induced chronic liver disease and autoimmune liver disease;

²Other cancers: Colon cancer, renal cell carcinoma, bladder cancer and ovarian cancer;

³P-value of comparison of patients falling under APASL, EASL and both criteria;

⁴Patients may have more than one cause of acute liver injury. TCM: Traditional Chinese Medicine; TIPSS: Transjugular intrahepatic portosystemic shunt; NASH: Non-alcoholic steatohepatitis; HCC: Hepatocellular carcinoma; APASL: Asia-Pacific Association for the Study of the Liver; EASL: European Association for the Study of the Liver.