387 163

Characteristics and Discrepancies in Acute-on-Chronic Liver Failure: Need for a Unified Definition

Title
Characteristics and Discrepancies in Acute-on-Chronic Liver Failure: Need for a Unified Definition
Author
김태엽
Keywords
ASIAN-PACIFIC ASSOCIATION; ORGAN FAILURE; CONSENSUS RECOMMENDATIONS; ACUTE DECOMPENSATION; CIRRHOTIC-PATIENTS; MORTALITY; VALIDATION; PROGNOSIS; DISTINCT; DISEASE
Issue Date
2016-01
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v. 11, NO 1, Article number e0146745, Page. 1-18
Abstract
Background & Aim To investigate the prevalence, mortalities, and patient characteristics of Acute-on-chronic liver failure (ACLF) according to the AARC (Asian Pacific Association for the Study of the Liver ACLF Research Consortium) and European Association for the Study of the Liver CLIF-C (Chronic Liver Failure Consortium) definitions. Methods We collected retrospective data for 1470 hospitalized patients with chronic liver disease (CLD) and acute deterioration between January 2013 and December 2013 from 21 university hospitals in Korea. Results Of the patients assessed, the prevalence of ACLF based on the AARC and CLIF-C definitions was 9.5% and 18.6%, respectively. The 28-day and 90-day mortality rates were higher in patients with ACLF than in those without ACLF. Patients who only met the CLIF-C definition had significantly lower 28-day and 90-day survival rates than those who only met the AARC definition (68.0% vs. 93.9%, P<0.001; 55.1% vs. 92.4%, P<0.001). Among the patients who had non-cirrhotic CLD, the 90-day mortality of the patients with ACLF was higher than of those without ACLF, although not significant (33.3% vs. 6.0%, P = 0.192). Patients with previous acute decompensation (AD) within 1-year had a lower 90-day survival rate than those with AD more than 1 year prior or without previous AD (81.0% vs. 91.9% or 89.4%, respectively, all P<0.001). Patients who had extra-hepatic organ failure without liver failure had a similar 90-day survival rate to those who had liver failure as a prerequisite (57.0% vs. 60.6%, P = 0.391). Conclusions The two ACLF definitions result in differences in mortality and patient characteristics among ACLF patients. We suggest that non-cirrhotic CLD, previous AD within 1 year, and extrahepatic organ failure should be included in the ACLF diagnostic criteria. In addition, further studies are necessary to develop a universal definition of ACLF.
URI
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0146745
ISSN
1932-6203
DOI
10.1371/journal.pone.0146745
Appears in Collections:
RESEARCH INSTITUTE[S](부설연구소) > ETC
Files in This Item:
Characteristics and Discrepancies in Acute-on-Chronic Liver Failure Need for a Unified Definition.pdfDownload
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE