The course and survival of patients with liver cirrhosis and acute liver failure on the background of chronic
https://doi.org/10.30629/0023-2149-2020-98-2-137-141
Abstract
Aims. We comparative investigated the frequency, precipitating factors, lifetimes and predictive factors of survival in patients with liver cirrhosis (LC) and acute-on-chronic liver failure (ACLF).
Material and methods. We collected data from 310 hospitalized patients with LC. Patients divided into groups: 1 — patients with compensation of LC; 2 — patients with decompensation of LC, but without organ failure (OF) and 3 — patients with ACLF. Diagnostic criteria for ACLF based on consensus recommendations of EASL. Survival was assessed according to the Kaplan-Meier method.
Results. 48 patients with LC reported clinical signs of ACLF. 28-day mortality was in 4,8% of patients without ACLF and in 42,0% of patients with ACLF. 90-day mortality of patients with ACLF was 50% versus 11.6% in patients without ACLF. 6-month survival rate of patients with the development of acute decompensation with organ failure was only 33,3%. The lifetimes of patients with ACLF was only 136,65 ± 18,96 days. The predictive factors of survival of patients with LC and ACLF are: the number of organ failure, indicators of CLIF-SOFA and MELD, Child-Pugh score, degree of hepatic encephalopathy, leukocytosis, hyperbilirubinemia, hypercreatininemia and increased INR.
Conclusion. The prevalence of ACLF in patients with LC is 15,5% and develops against a background of stable compensated or decompensated CP. The frequent trigger of ACLF is infection, which causes acute decompensation with the development of multiple organ failure and a high incidence of short-term mortality. The 28-day mortality rate in patients with ACLF was 8.7 times greater than the mortality rate in patients with decompensated LC without ACLF.
About the Authors
S. A. Avezov
Institute of Gastroenterology
Tajikistan
Avezov Sayfullo — MD, PhD
734063, Dushanbe
Tajikistan
Avezov Sayfullo — MD, PhD
734063, Dushanbe
S. M. Azimova
Institute of Gastroenterology
Tajikistan
734063, Dushanbe
Tajikistan
734063, Dushanbe
M. H. Abdulloev
Institute of Gastroenterology
Tajikistan
734063, Dushanbe
Tajikistan
734063, Dushanbe
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Review
For citations:
Avezov S.A., Azimova S.M., Abdulloev M.H. The course and survival of patients with liver cirrhosis and acute liver failure on the background of chronic. Clinical Medicine (Russian Journal). 2020;98(2):137-141. (In Russ.) https://doi.org/10.30629/0023-2149-2020-98-2-137-141
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