Acute‐on‐chronic liver failure: Epidemiology, prognosis, and outcome of a multicenter study in Thai population

Chirapongsathorn, Sakkarin; Teerasarntipan, Tongluk; Tipchaichatt, Krit; Suttichaimongkol, Tanita; Chamroonkul, Naichaya; Bunchorntavakul, Chalermrat; Siramolpiwat, Sith; Chainuvati, Siwaporn; Sobhonslidsuk, Abhasnee; Leerapun, Apinya; Piratvisuth, Teerha; Sukeepaisarnjaroen, Wattana; Tanwandee, Tawesak; Treeprasertsuk, Sombat

doi:10.1002/jgh3.12719

Cited by 5 publications

(4 citation statements)

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“…Aggressive alcohol intake, alcoholic hepatitis, and bacterial infection were the most common causes of ACLF in alcohol liver disease[ 48 ]. The AUROCs of the CLIF-SOFA, CLIF-OF, and CLIF-C scores showed a slight superior effect in estimating short-term mortality; however, they were equivalent to MELD and MELD-Na[ 49 ]. To clarify this finding, Chirapongsathorn et al [ 49 ] had elevated short- and long-term mortality rates.…”

Section: Discussionmentioning

confidence: 99%

“…The AUROCs of the CLIF-SOFA, CLIF-OF, and CLIF-C scores showed a slight superior effect in estimating short-term mortality; however, they were equivalent to MELD and MELD-Na[ 49 ]. To clarify this finding, Chirapongsathorn et al [ 49 ] had elevated short- and long-term mortality rates. In patients with ACLF, as per the CLIF-C definition, the prediction accuracy of the CLIF-SOFA, CLIF-OF and CLIF-C scoring tools were no better than the accuracy of MELD and MELD-Na scores.…”

Section: Discussionmentioning

confidence: 99%

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CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review

Rashed¹,

Soldera²

2022

World J Hepatol

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BACKGROUND Acute-on-chronic liver failure (ACLF) is a syndrome characterized by decompensation in individuals with chronic liver disease, generally secondary to one or more extra-hepatic organ failures, implying an elevated mortality rate. Acute decompensation (AD) is the term used for one or more significant consequences of liver disease in a short time and is the most common reason for hospital admission in cirrhotic patients. The European Association for the Study of Liver-Chronic-Liver Failure (EASL-CLIF) Group modified the intensive care Sequential Organ Failure Assessment score into CLIF-SOFA, which detects the presence of ACLF in patients with or without AD, classifying it into three grades . AIM To investigate the role of the EASL-CLIF definition for ACLF and the ability of CLIF-SOFA, CLIF-C ACLF, and CLIF-C AD scores for prognosticating ACLF or AD. METHODS This study is a literature review using a standardized search method, conducted using the steps following the guidelines for reporting systematic reviews set out by the PRISMA statement. For specific keywords, relevant articles were found by searching PubMed, ScienceDirect, and BioMed Central-BMC. The databases were searched using the search terms by one reviewer, and a list of potentially eligible studies was generated based on the titles and abstracts screened. The data were then extracted and assessed on the basis of the Reference Citation Analysis ( ). RESULTS Most of the included studies used the EASL-CLIF definition for ACLF to identify cirrhotic patients with a significant risk of short-term mortality. The primary outcome in all reviewed studies was mortality. Most of the study findings were based on an area under the receiver operating characteristic curve (AUROC) analysis, which revealed that CLIF-SOFA, CLIF-C ACLF, and CLIF-C AD scores were preferable to other models predicting 28-d mortality. Their AUROC scores were higher and able to predict all-cause mortality at 90, 180, and 365 d. A total of 50 articles were included in this study, which found that the CLIF-SOFA, CLIF-C ACLF and CLIF-C AD scores in more than half of the articles were able to predict short-term and long-term mortality in patients with either ACLF or AD. CONCLUSION CLIF-SOFA score surpasses other models in predicting mortality in ACLF patients, especially in the short-term. CLIF-SOFA, CLIF-C ACLF, and CLIF-C AD are accurate short-term and long-term mortality prognosticating scores.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review

Rashed¹,

Soldera²

2022

World J Hepatol

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“…In his study, Masnou et al (12) showed that approximately 83 percent of cases had nearly identifiable triggering circumstances gastrointestinal bleeding (53 percent) and infection were the most common triggering causes (19 percent). Sepsis (50 percent) was the most frequent factor that caused ACLF, according to Chirapongsathorn et al (13) across all grades of ACLF, the frequency of multiple organ failures other than liver failure was significantly higher in ACLF patients. The variables that demonstrated a significant correlation with ACLF across grades were total leukocyte count, INR, and serum creatinine.…”

Section: Disscusionmentioning

confidence: 96%

Acute-on-Chronic Liver Failure in Zagazig University Hospital: A Single Center-Based Study

Eltaweel¹,

Emam²,

Mohamed³

2022

The Egyptian Journal of Hospital Medicine

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Background : Chronic or acute liver failure is a common condition that has a number of contributing variables; a high death rate and a dismal prognosis. The mainstay of these individuals' survival chances is liver transplantation. Objectives: To identify the prevalence of acute-on-chronic liver failure (ACLF) and to characterize patients admitted with ACLF according to the European association for the study of liver (EASL) definition of ACLF to determine the possible risk and precipitating factors and show the outcomes. Patients and Method: Prospective study in a single tertiary University hospital was conducted for 1 year duration, comparing cirrhotic patients with or without ACLF according to EASL-ACLF criteria. Results: The prevalence rate of ACLF was 57.9% of the studied populations. GIT bleeding, HE, and active infections were the most frequent precipitating factors. Patients who have ACLF had a high 28-day mortality rate (67.3%). The rate of mortality was significantly greater with the grade of ACLF. Chronic liver failure (CLIF) score of more than 5 was associated with 86.84% sensitivity, 45.95% specificity, 63% negative predictive value, 76.7% positive predictive value as well as 0.661 AUC. Conclusion:A common illness with a high death rate is ACLF. The primary triggering causes include GIT hemorrhage, HE, and active infection. High sensitivity and positive predictive value, but low specificity and negative predictive value are associated with a CLIF score of more than five for mortality in ACLF patients.

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“…Acute on chronic liver failure is a serious clinical syndrome characterized by acute liver dysfunction in patients with chronic liver disease, which has a high mortality rate and poor prognosis (1). In China, hepatitis B virus infection is the leading cause of acute on chronic liver failure.…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemia on admission in patients with acute on chronic liver failure: a retrospective cohort analyzing the current situation, risk factors, and associations with prognosis

Yang¹,

Liu²,

Wang³

et al. 2023

Ann Palliat Med

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Background: Hypoglycemia is a common phenomenon in patients with various severe liver diseases.However, its implications for the prognosis of patients with acute on chronic liver failure remains largely unknown. This study investigated the status of hypoglycemia in patients with acute on chronic liver failure, as well as its risk factors and correlation with 90-day patient outcomes.Methods: A total of 218 patients with acute on chronic liver failure diagnosed and treated in our hospital from January 2019 to August 2021 were enrolled. Hypoglycemia is defined as a fasting blood glucose level ≤2.8 mmol/L. Baseline data on the patients' clinical characteristics and laboratory examinations were collected. Patients were followed-up with a primary outcome of 90-day mortality. The risk factors for hypoglycemia were identified by univariate and multivariate logistic regression.Results: A total of 99 cases (45.41%) had hypoglycemia. Liver cirrhosis [odds ratio (OR) =5.16, P<0.001] and a higher model for end-stage liver disease (MELD) score (OR =1.29, P<0.001) were risk factors for hypoglycemia in acute on chronic liver failure, while higher fibrinogen (FIB) was a protective factor for hypoglycemia (OR =0.17, P=0.001). The 90-day mortality rate in the hypoglycemia group was significantly higher than that in the non-hypoglycemia group (72.73% vs. 48.74%, P<0.001). After adjusting for hepatic encephalopathy, cirrhosis, and MELD scores, hypoglycemia (OR =8.72, P=0.01) was still an independent risk factor for 90-day mortality in patients with acute on chronic liver failure.Conclusions: Hypoglycemia is common in patients with acute on chronic liver failure and is related to poor prognosis. Patients with cirrhosis, a higher MELD score, and a significant decrease in FIB are more likely to develop hypoglycemia. Thus whether ameliorating hypoglycemia could improve patient outcomes deserves additional investigations.

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Acute‐on‐chronic liver failure: Epidemiology, prognosis, and outcome of a multicenter study in Thai population

Cited by 5 publications

References 12 publications

CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review

CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review

Acute-on-Chronic Liver Failure in Zagazig University Hospital: A Single Center-Based Study

Hypoglycemia on admission in patients with acute on chronic liver failure: a retrospective cohort analyzing the current situation, risk factors, and associations with prognosis

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