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©The Author(s) 2016.
World J Hepatol. Dec 8, 2016; 8(34): 1529-1534
Published online Dec 8, 2016. doi: 10.4254/wjh.v8.i34.1529
Published online Dec 8, 2016. doi: 10.4254/wjh.v8.i34.1529
Table 1 Chronic liver failure-sequential organ failure assessment score
Organ/system | 0 | 1 | 2 | 3 | 4 |
Liver (bilirubin, mg/dL) | < 1.2 | ≥ 1.2 to ≤ 2 | ≥ 2 to < 6 | ≥ 6 to < 12 | ≥ 12 |
Kidney (creatinine, mg/dL) | < 1.2 | ≥ 1.2 to < 2 | ≥ 2 to < 3.5 | ≥ 3.5 to < 5 or dialysis | ≥ 5 or diálysis |
Cerebral (HE grade) | No HE | I | II | III | IV |
Coagulation (RIN, platelet count) | < 1.1 | ≥ 1.1 to < 1.25 | ≥ 1.25 to < 1.5 | ≥ 1.5 to < 2.5 | ≥ 2.5 or platelet count ≤ 20000 per cubic millimeter |
Circulation (mean arterial pressure, mmHg), inotropic drugs (μg/kg per minute) | ≥ 70 | < 70 | Dopamine ≤ 5 or dobutamine or terlipressin | Dopamine > 5 or E ≤ 0.1 or NE ≤ 0.1 | Dopamine > 15 or E > 0.1 or NE > 0.1 |
Lungs (SpO2/FiO2) | > 512 | > 357 a ≤ 512 | > 214 a ≤ 357 | > 89 to ≤ 214 | ≤ 89 |
Table 2 Cirrhosis etiology
Etiology | n (%) |
Alcohol | 58 (58) |
Alcohol + hepatitis C virus | 5 (5) |
Hepatitis C virus | 13 (13) |
Nonalcoholic steatohepatitis | 4 (4) |
Cryptogenic | 12 (12) |
Autoimmune hepatitis | 4 (4) |
Primary biliary cirrosis | 1 (1) |
Primary biliary cirrhosis + autoimmune hepatitis | 1 (1) |
Hepatitis B virus + alcohol | 1 (1) |
Hemochromatosis | 1 (1) |
Table 3 Prevalence of acute on chronic liver failure n (%)
ACLF | Grade 1 | Grade 2 | Grade 3 |
Patients | 10 (34.4) | 5 (17.3) | 14 (48.3) |
Mortality | 3 (30) | 2 (40) | 13 (92) |
Table 4 Type and number of organ failure n (%)
Organs failure | ACLF 1 | ACLF 2 | ACLF 3 |
Renal | 7 (70) | 2 (40) | 10 (71) |
Cerebral | 1 (10) | 1 (20) | 12 (85) |
Coagulation | 1 (10) | 3 (60) | 8 (57) |
Liver | 1 (10) | 1 (20) | 2 (14) |
Circulatory | 0 (0) | 1 (20) | 14 (100) |
Respiratory | 1 (10) | 2 (40) | 14 (100) |
Table 5 Precipitating events of acute-on-chronic liver failure
Potential precipitating events of ACLF | n (%) |
Bacterial infection | 12 (41.3) |
Gastrointestinal hemorrhage | 8 (27.5) |
Renal failure secondary to acute diarrhea | 1 (3.4) |
No precipitating event | 8 (27.5) |
Table 6 Comparative results between groups with and without acute on chronic liver failure n (%)
ACLF | No ACLF | P vaule | OR | 95%CI | |
Age (yr ± SD) | 60 ± 11 | 60 ± 11 | 1.00 | ||
Male | 23 (79) | 44 (62) | 0.11 | 2.3 | 0.78-7.43 |
Child Pugh (score ± DS) | 10.2 ± 2.1 | 8.4 ± 1.6 | < 0.0001 | ||
MELD (score ± DS) | 20.7 ± 8.5 | 12.3 ± 4 | < 0.0001 | ||
Active alcoholism | 9 (31) | 22 (31) | 1.00 | 1 | 0.3-2.8 |
Prior ascites | 18 (62) | 29 (41) | 0.07 | 2.3 | 0.9-6.3 |
Prior encephalopthy, n (%) | 9 (31) | 10 (14) | 0.08 | 2.74 | 0.9-8.7 |
Esophageal varices | 18 (62) | 37 (52) | 0.38 | 1.5 | 0.5-4 |
Ascites | 27 (93) | 43 (60.5) | 0.001 | 8.8 | 1.8-58.1 |
Variceal hemorrhage | 4 (13.7) | 10 (14) | 1 | 0.97 | 0.2-3.8 |
White cell count (n/mm3± SD) | 15.300 ± 10.770 | 8.033 ± 5.601 | < 0.0001 | ||
Serum sodium (mEq/L ± SD) | 133.3 ± 6.9 | 135.1 ± 5.3 | 0.16 | ||
CRP (mg/L ± SD) | 50.9 ± 46.4 | 28.6 ± 23.4 | 0.002 | ||
Mortality | 18 (62) | 4 (5.6) | < 0.0001 |
- Citation: Dominguez C, Romero E, Graciano J, Fernandez JL, Viola L. Prevalence and risk factors of acute-on-chronic liver failure in a single center from Argentina. World J Hepatol 2016; 8(34): 1529-1534
- URL: https://www.wjgnet.com/1948-5182/full/v8/i34/1529.htm
- DOI: https://dx.doi.org/10.4254/wjh.v8.i34.1529