Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2024; 16(5): 809-821
Published online May 27, 2024. doi: 10.4254/wjh.v16.i5.809
Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study
Yuan-Yao Zhang, Sen Luo, Hai Li, Shu-Ning Sun, Xian-Bo Wang, Xin Zheng, Yan Huang, Bei-Ling Li, Yan-Hang Gao, Zhi-Ping Qian, Feng Liu, Xiao-Bo Lu, Jun-Ping Liu, Hao-Tang Ren, Yu-Bao Zheng, Hua-Dong Yan, Guo-Hong Deng, Liang Qiao, Yan Zhang, Wen-Yi Gu, Xiao-Mei Xiang, Yi Zhou, Yi-Xin Hou, Qun Zhang, Yan Xiong, Cong-Cong Zou, Jun Chen, Ze-Bing Huang, Xiu-Hua Jiang, Ting-Ting Qi, Yuan-Yuan Chen, Na Gao, Chun-Yan Liu, Wei Yuan, Xue Mei, Jing Li, Tao Li, Rong-Jiong Zheng, Xin-Yi Zhou, Jun Zhao, Zhong-Ji Meng
Yuan-Yao Zhang, Sen Luo, Yuan-Yuan Chen, Zhong-Ji Meng, Department of Infectious Disease, Institute of Biomedical Research, Regulatory Mechanism and Targeted Therapy for Liver Cancer Shiyan Key Laboratory, Hubei provincial Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Hai Li, Yan Zhang, Wen-Yi Gu, Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China
Shu-Ning Sun, Guo-Hong Deng, Xiao-Mei Xiang, Yi Zhou, Department of Infectious Diseases, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400000, China
Xian-Bo Wang, Yi-Xin Hou, Qun Zhang, Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100020, China
Xin Zheng, Yan Xiong, Cong-Cong Zou, Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430020, Hubei Province, China
Yan Huang, Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha 110051, Hunan Province, China
Bei-Ling Li, Xiu-Hua Jiang, Ting-Ting Qi, Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Yan-Hang Gao, Na Gao, Chun-Yan Liu, Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Zhi-Ping Qian, Wei Yuan, Xue Mei, Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai 200093, China
Feng Liu, Tianjin Institute of Hepatology, Nankai University Second People's Hospital, Tianjin 300192, China
Xiao-Bo Lu, Yi Zhou, Rong-Jiong Zheng, Xin-Yi Zhou, Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Jun-Ping Liu, Jing Li, Tao Li, Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan 250000, Shandong Province, China
Hao-Tang Ren, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Yu-Bao Zheng, Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Hua-Dong Yan, Department of Infectious Diseases, Ningbo No. 2 Hospital, University of Chinese Academy of Sciences, Ningbo 315153, Zhejiang Province, China
Liang Qiao, Department of Gastroenterology, The 455th Hospital of Chinese People's Liberation Army, Shanghai 200052, China
Jun Chen, Ze-Bing Huang, Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Nation Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Jun Zhao, School of Public Health, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Author contributions: Meng ZJ and Li H contributed to the conception and design of the study. Li H, Zheng X, Huang Y, Meng ZJ, Gao YH, Qian ZP, Liu F, Lu XB, Liu JP, Deng GH, Zheng YB, Yan HD, Qiao L, Zhang Y, Gu WY, Xiang XM, Zhou Y, Sun SN, Hou YX, Zhang Q, Xiong Y, Zou CC, Chen J, Huang ZB, Jiang XH, Qi TT, Luo S, Chen YY, Gao N, Liu CY, Yuan W, Mei X, Li J, Li T, Zheng RJ, Zhou XY, and Ren HT contributed to the acquisition, analysis, or interpretation of data; Zhang YY wrote the original draft of the manuscript; Zhang YY and Zhao J performed the statistical analysis. Meng ZJ and Li H performed critical revision of the manuscript for important intellectual content; All authors read and approved the final version of the submitted manuscript.
Supported by The National Science and Technology Major Project, No. 2018ZX10723203 and No. 2018ZX10302206; Hubei Province’s Outstanding Medical Academic Leader Program, Advantage Discipline Group (Public Health) Project in Higher Education of Hubei Province, No. 2023PHXKQ1; The Foundation of Health Commission of Hubei Province, No. WJ2021F037 and No. WJ2021M051; Project of Hubei University of Medicine, No. FDFR201902 and No. YC2023047; and The Hubei Provincial Technology Innovation Project, No. 2023BCB129.
Institutional review board statement: This study was approved by the Ethics Committee of Renji Hospital (the leading center of the CATCH-LIFE study), School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Clinical trial registration statement: This study is registered at https://clinicaltrials.gov/. The registration identification number is NCT02457637.
Informed consent statement: Signed informed consent was obtained from all patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Ji Meng, MD, Chief Doctor, Full Professor, Research Scientist, Department of Infectious Disease, Taihe Hospital, Hubei University of Medicine, No. 32 South Renmin Road, Shiyan 442000, Hubei Province, China. zhongji.meng@163.com
Received: November 29, 2023
Revised: February 9, 2024
Accepted: April 9, 2024
Published online: May 27, 2024
Processing time: 175 Days and 1.2 Hours
Core Tip

Core Tip: This study systematically investigated the composition, clinical characteristics, and prognosis of each subtype of acute-on-chronic liver disease (AoCLD) for the first time. In China, liver cirrhosis acute decompensation (LC-AD) is the most common clinical type of AoCLD, with a high short-term mortality rate. Attention should be given to the early diagnosis and intervention of patients with LC-AD to avoid acute decompensation-acute-on-chronic liver failure (ACLF) transition. Type C ACLF patients have the highest mortality rate, requiring early liver transplantation to improve the overall survival rate of AoCLD.