Perihepatic nodes detected by point-of-care ultrasound in acute hepatitis and acute-on-chronic liver disease

Table 1 Nodal manifestations of variable etiologies in this study cohort, number of cases (n), gender distribution, nodal prevalence (WT ≥ 5 mm) and nodal width (WT) values (medium and mean)

Diagnosis according to etiology	n	Gender (%) male/female	WT≥5 mm (Yes/No) (%)	WT, median (Q1, Q3)	WT, mean ± SD
Viral
CHBwAE	77	64.9/35.1	77.9/22.1	6.5 (5, 8)	6.32 ± 3.245
CHCwAE	11	63.6/36.4	100/0	6.1 (5, 7)	6.79 ± 2.23
Acute A	5	60/40	100/0	13 (13, 14)	15.12 ± 7.76
Acute B	11	54.5/45.5	63.6/36.4	6.8 (4, 8.1)	6.35 ± 3.27
Acute C	6	50/50	100/0	8.15 (8, 9)	7.92 ± 1.41
Non-viral
AIH	10	20/80	50/50	4.65 (0, 7)	3.83 ± 3.51
AH	9	88.9/11.1	44.4/55.6	3.3 (0, 7.6)	3.77 ± 3.84
DILI	24	37.5/62.5	29.2/70.8	0 (0, 5.1)	2.08 ± 2.90
Infective	13	30.8/69.2	30.8/69.2	0 (0, 5.2)	2.57 ± 3.16
Ischemic	10	70/30	10/90	0 (0, 5.2)	0.90 ± 1.91

CHBwAE: Chronic B hepatitis with acute flare; CHCwAE: Chronic C hepatitis with acute flare; Acute A: Acute hepatitis A; Acute B: Acute hepatitis B; Acute C: Acute hepatitis C; AIH: Autoimmune hepatitis; AH: Alcoholic hepatitis; DILI: Drug induced liver injury; Infective: Infective hepatitis; Ischemic: Ischemic hepatitis; WT: Width.

Table 2 Demographic differences between viral and non-viral groups

	Viral group (n = 110)	Non-viral group (n = 66)	P value
Gender (%) male/female	62.7/37.3	45.5/54.5	0.025
Age (years), mean ± SD	40 ± 14.63	52.47 ± 17.82	< 0.001
ALT (IU/L), median (Q1-Q3)	1055 (516.8-1869)	821 (316-1520)	0.022
Total bilirubin (mg/dL), median (Q1-Q3)	1.57 (0.72-5.15)	2.49 (0.98-5.92)	0.335
AFP (ng/mL), median (Q1-Q3)	8.22 (4.60-18.83)	4.7 (0-7.6)	< 0.001
WBC (/μL), median (Q1-Q3)	5900 (5000-7500)	7200 (5700-9500)	0.003
PLT (103/μL), median (Q1-Q3)	186 (151-251)	206.5 (142-263)	0.543
WT, median (Q1-Q3)	7 (5-8.9)	0 (0-5.4)	< 0.001
Gallbladder wall thickening (%) (Yes/No)	32.7/67.3	30.3/69.7	0.738
Echogenecity (%) (1/0)	30.6/69.4	20.3/79.7	0.142
LN5 (%) (Yes/No)	80.9/19.1	31.8/68.2	< 0.001

Clinical and biochemical characteristics of patients are expressed as median. Data were tested by U test (Mann-Whitney) and Wilcoxon test, and P < 0.05 was judged to be statistically significant. WT: Value of nodal width; Echogenecity: Chronic liver parenchymal change; 1: Positive, 0: Negative; LN5: Nodal width ≥ 5 mm. ALT: Alanine aminotransferase; AFP: α-fetoprotein; PLT: Platelet; WBC: White blood cell.

Table 3 Logistical regression analysis between viral and non-viral groups

Variables	Univariate analysis			Multivariate analysis
	OR	95%CI	P value	OR	95%CI	P value
Gender (M/F)	2.020	1.087-3.753	0.026	0.280	0.108-0.725	0.009
Age (yr)	1.048	1.027-1.069	< 0.0001	1.033	1.001-1.065	0.04
ALT (IU/100 L)	0.982	0.956-1.008	0.982	0.973	0.929-1.019	0.24
Total bilirubin	1.011	0.961-1.064	0.665	1.239	1.096-1.401	0.001
AFP (ng/mL)	0.992	0.982-1.003	0.141	0.971	0.955-0.987	< 0.0001
WBC (/100 μL)	1.018	1.006-1.030	0.003	1.026	1.008-1.045	0.006
PLT (103/μL)	1.002	0.998-1.005	0.391	1.003	0.997-1.009	0.352
Gallbladder wall thickening	0.894	0.462-1.727	0.738	0.579	0.198-1.696	0.319
Echogenecity	0.579	0.278-1.207	0.579	0.803	0.272-2.370	0.691
WT	0.687	0.612-0.771	< 0.0001	0.627	0.530-0.741	< 0.0001

The gender, age, WBC level and the nodal width had significant differences in univariate analysis (P = 0.026, < 0.0001, 0.003 and < 0.0001, respectively). The nodal width remains strong significance in multivariate analysis (P < 0.0001). WT: Value of nodal width. ALT: Alanine aminotransferase; AFP: α-fetoprotein; PLT: Platelet; WBC: White blood cell.