Acute on Chronic Liver Failure—In-Hospital Predictors of Mortality in ICU

Chauhan

Digestive and Liver Disease

et al. 2019

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Predictive factors for 28-day mortality in acute-on-chronic liver failure patients admitted to the intensive care unit

Chauhan

Digestive and Liver Disease

et al. 2019

“…This is compatible with other studies, which have shown CLIF-SOFA to be superior to other liver-specific scores in predicting mortality. [34][35][36] This has been demonstrated for short term for alcoholic cirrhosis in a previous study, in comparison to other liver-specific scores. 37 It has been demonstrated to be superior to CLIF-C AD or ACLF, MELD and MELD-Na in other previous study, even for extra-hepatic insults.…”

Section: Discussionsupporting

confidence: 52%

Liver‐specific scores as predictors of mortality in spontaneous bacterial peritonitis

Jacques

Massignan

Winkler³

et al. 2020

GastroHep

Background Liver‐specific scores have been developed and are currently used to predict mortality in cirrhotic patients. The purpose of this study is to analyse and compare their ability to predict mortality in cirrhotic patients with spontaneous bacterial peritonitis. Design and setting Historical cohort study conducted in a public tertiary care teaching hospital. Methods Data from medical records from January 2009 to July 2016 were obtained by searching the hospital electronic database for samples of ascites collected in the period. Electronic and physical medical records were hand analysed and patients were included if they were over 18‐year old, with cirrhosis and an ascites fluid compatible with spontaneous bacterial peritonitis. It was included 69 patients. Liver‐specific scores were calculated and ROC curves pairwise comparisons were performed using DeLong test. Results Chronic Liver Failure‐Sequential Organ Failure Assessment (CLIF‐SOFA) was able to predict mortality in 30, 90 and 365 days, with AUROC of 0.75, 0.64 and 0.64 respectively. Values of CLIF‐SOFA above 5 was able to predict higher mortality for all patients, with sensitivity of 87%, 74% and 56% and specificity of 52%, 46% and 66% for 28‐, 90‐ and 365‐day mortality respectively (P < .05). CLIF‐SOFA was able to predict mortality in every time frame for all patients and acute‐on‐chronic liver failure (ACLF) patients. CLIF‐SOFA values above 7 were associated with higher mortality for ACLF patients. Conclusion CLIF‐SOFA score was superior to other liver‐specific scores for predicting mortality in a cohort of cirrhotic patients admitted due to spontaneous bacterial peritonitis in a teaching hospital in Brazil.

Euroasian Journal of Hepato-Gastroenterology

“… 19 Multiple studies from different centers of India have reported alcohol to be the commonest cause of cirrhosis with prevalence ranging from 30% to 70% of all cases of cirrhosis. 20 – 26 Patil et al reported that the main etiology of cirrhosis was ethanol-related (38%) followed by NASH-related (24%), hepatotropic viruses (22%), and cryptogenic cirrhosis (17%). 27 However, contrary to most reports, Ray from Kolkata reported that alcohol was overall the third most common cause of CLD after cryptogenic (36.5%) and viral hepatitis (33.2%) for the entire period of study from 2003 to 2011; however, this study too demonstrated that over time, during the last year of their study period, alcohol emerged as the commonest cause of cirrhosis of the liver.…”

Section: Discussionmentioning

confidence: 99%

A Study on the Temporal Trends in the Etiology of Cirrhosis of Liver in Coastal Eastern Odisha

Mishra¹,

Dash²,

Khatua³

et al. 2020

Background The etiology of cirrhosis of liver is known to change with time due to various factors including awareness, preventive interventions, and lifestyle changes in society. However, there is scarce Indian data available about temporal trends in etiology of cirrhosis of liver. Hence, the aim of this study was to study the temporal trends in the etiology of cirrhosis of liver. Materials and methods This is a retrospective study conducted in the Department of Gastroenterology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, from January 2005 to December 2017. Data were collected from hospital records of all patients admitted to the Gastroenterology unit. A Poisson regression model was used to compare the hospitalization rate for different etiologies of cirrhosis of liver. All data were analyzed using Stata version 5.1 software. Results A total of 4,331 hospitalized patients of cirrhosis of liver were included in the analysis, of whom 2,742 (63.3%) had alcohol-related cirrhosis, 858 (19.8%) had viral hepatitis-related cirrhosis, and 731 (16.9%) had cirrhosis of liver due to nonalcohol and nonviral causes. The proportion of alcohol-related cirrhosis was increased by 26% from 2005 to 2017 (RR 1.26, p for trend <0.001). Though there were minimal ups and downs observed in the admission rate of viral hepatitis-related liver cirrhosis during later years, this was remarkably reduced by 73% (RR 0.27, p for trend <0.001) in the year 2017 at the end of the study. Similarly, the proportion of cirrhosis due to nonalcohol and nonviral causes decreased by 26% (RR 0.74, p for trend <0.001) by 2017. Conclusion Alcohol is the most common cause of cirrhosis of liver and the burden of alcohol-related cirrhosis is significantly increasing in comparison to other causes including viral infection, nonalcoholic steatohepatitis (NASH), and autoimmune hepatitis. How to cite this article Mishra D, Dash KR, Khatua C, et al. A Study on the Temporal Trends in the Etiology of Cirrhosis of Liver in Coastal Eastern Odisha. Euroasian J Hepato-Gastroenterol 2020;10(1):1–6.