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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 552-564
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.552
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.552
Role of ammonia in predicting the outcome of patients with acute-on-chronic liver failure
Stefan Chiriac, Camelia Cojocariu, Ana-Maria Singeap, Catalin Sfarti, Tudor Cuciureanu, Irina Girleanu, Anca Trifan, Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
Stefan Chiriac, Carol Stanciu, Camelia Cojocariu, Ana-Maria Singeap, Catalin Sfarti, Irina Girleanu, Anca Trifan, Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, Iasi 700111, Romania
Razvan Alexandru Igna, Intensive Care, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
Author contributions: Chiriac S wrote the original draft of the manuscript and performed the statistical analysis; Stanciu C coordinated the manuscript drafting and revised it critically; Cojocariu C designed the methodology and edited the manuscript; Singeap A, Cuciureanu T, Girleanu I and Sfarti C participated in the writing of the manuscript and performed the acquisition of data; Igna RA participated in the analysis and interpretation of data; Trifan A, conceptualized and critically revised the manuscript for important intellectual content; all authors read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania.
Informed consent statement: There was no requirement for the informed written consent because of the retrospective nature of the study; all of the patients signed an informed consent upon hospitalization agreeing to receive treatment.
Conflict-of-interest statement: The authors declare no conflict of interest in relation to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Camelia Cojocariu, MD, PhD, Assistant Professor, Doctor, Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, Iasi 700115, Iasi, Romania. cameliacojocariu@yahoo.com
Received: October 3, 2020
Peer-review started: October 3, 2020
First decision: November 23, 2020
Revised: December 2, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 26, 2021
Peer-review started: October 3, 2020
First decision: November 23, 2020
Revised: December 2, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 26, 2021
Core Tip
Core Tip: Hyperammonemia has been associated with hepatic encephalopathy and high mortality in patients with liver cirrhosis. Acute-on-chronic liver failure is a relatively new defined syndrome presenting high 28-d mortality. The role of hyperammonemia in acute-on-chronic liver failure has not yet been clearly established. Venous ammonia presents a good predictive value for in-hospital mortality in patients with acute-on-chronic liver failure (ACLF), with a cut-off value of 152.5 μmol/L, sensitivity = 0.706, 1-specificity = 0.190 and is associated with severe hepatic encephalopathy in patients with ACLF. Thus, venous ammonia has the potential to be used as a prognostic marker in the evaluation of patients with ACLF.