Role of ammonia in predicting the outcome of patients with acute-on-chronic liver failure

Table 4 Comparison of patient characteristics based on the presence of hepatic encephalopathy

Variable	HE, n (%) 374 (83.9)	No. HE, n (%) 72 (16.1)	P value
Age, median (IQR)	60 (50-65)	56 (47-65)	0.413
Male sex, n (%)	211 (56.4)	45 (62.5)	0.339
Albumin (g/dL), mean ± SD	2.33 ± 0.55	2.60 ± 0.74	< 0.001
Bilirubin (mg/dL), median (IQR)	2.62 (1.54-5.11)	1.72 (0.73-3.30)	0.015
INR, median (IQR)	1.49 (1.31-1.75)	1.34 (1.14-1.57)	0.054
Creatinine (mg/dL), median (IQR)	0.82 (0.63-1.26)	0.77 (0.62-1.32)	0.520
Platelets (× 109/L), median (IQR)	127 (90-173)	154 (93-193.5)	0.054
WBC (×109/L), median (IQR)	7.5 (5.41-10.45)	7.12 (5.76-9.09)	0.898
CRP (mg/dL), median (IQR)	1.53 (0.83-3.15)	1.29 (0.72-2.24)	0.795
Venous ammonia (μmol/L), median (IQR)	111 (86-158)	74 (60-93)	< 0.001
Venous ammonia > 152.5 μmol/L, n (%)	96 (26.6)	3 (4.5)	< 0.001
Sodium (mmol/L), median (IQR)	134 (129-137)	135 (131-138)	0.883
Child-Pugh score, median (IQR)	11 (10-12)	9 (8-11)	< 0.001
Child-Pugh class, n (%)
A	1 (0.3)	2 (3)
B	47 (12.7)	37 (55.2)
C	322 (87)	28 (41.8)
MELD, mean ± SD	19.74 ± 6.88	15.97 ± 5.24	< 0.001
AARC score, median (IQR)	7 (6-8)	9 (9-11)	< 0.001
ACLF, n (%)
Grade I	224 (59.9)	72(100)
Grade II	139 (37.2)	0
Grade III	11 (2.9)	0
Ascites, n (%)	337 (90.1)	71 (98.6)	0.018
Upper GI bleeding, n (%)	71 (19)	18 (25)	0.247
SBP, n (%)	23 (6.1)	1 (1.4)	0.150
Other infections, n (%)	64 (17.1)	6 (8.3)	0.061
AKI, n (%)	51 (13.6)	1 (1.4)	0.003
HCC, n (%)	10 (2.7)	1 (1.4)	0.520
Hospital stay (d), median (IQR)	8 (6-11)	5 (3-10)	0.061
In-hospital death rate, n (%)	33 (8.8)	2 (2.8)	0.081

IQR: Interquartile range; SD: Standard deviation; INR: International normalized ratio; WBC: White blood cells; CRP: C-reactive protein; MELD: Model for end-stage liver disease; AARC score: APASL ACLF Research Consortium score; HE: Hepatic encephalopathy; GI: Gastrointestinal; AKI: Acute kidney injury; SBP: Spontaneous bacterial peritonitis; HCC: Hepatocellular carcinoma.