Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors
- Title
- Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors
- Author
- 손주현
- Keywords
- acute-on-chronic liver failure; decompensation; organ failure; survival
- Issue Date
- 2019-02
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Citation
- JOURNAL OF CLINICAL GASTROENTEROLOGY, v. 53, NO 2, Page. 134-141
- Abstract
- Goals: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). Background: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. Study: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed. ACLF was defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium definition. Results: The mean follow-up duration was 19.4 +/- 9.9 months. In the subgroup of patients without previous acute decompensation (AD), ACLF occurrence did not affect long-term outcomes. However, in patients with previous AD, ACLF negatively affected long-term transplant-free survival even after overcoming ACLF (hazard ratio, 2.00, P=0.012). Previous AD was the significant predictive factor of long-term mortality and was independent of the Model for End-stage Liver Disease score in these ACLF-surviving patients. Organ failure severity did not affect transplant-free survival in patients who survived an ACLF episode. Conclusions: A prior history of AD is the most important factor affecting long-term outcomes following an ACLF episode regardless of Model for End-stage Liver Disease score. Prevention of a first AD episode may improve the long-term transplant-free survival of liver cirrhosis patients.
- URI
- https://insights.ovid.com/crossref?an=00004836-201902000-00015https://repository.hanyang.ac.kr/handle/20.500.11754/108223
- ISSN
- 0192-0790; 1539-2031
- DOI
- 10.1097/MCG.0000000000000987
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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