Characteristics, risk factors, and mortality of cirrhotic patients hospitalized for hepatic encephalopathy with and without acute-on-chronic liver failure (ACLF)

Córdoba, Juan; Ventura-Cots, Meritxell; Simón-Talero, Macarena; Amorós, Àlex; Pavesi, Marco; Vilstrup, Hendrik; Angeli, Paolo; Domenicali, Marco; Ginès, Pere; Bernardi, Mauro; Arroyo, Vicente

doi:10.1016/j.jhep.2013.10.004

Cited by 277 publications

(237 citation statements)

References 21 publications

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“…Cerebral edema has been observed in ACLF, and even low-grade HE can be detected by CT and MRI. As in ALF, ammonia-focused therapy constitutes the basis of current therapy for hepatic encephalopathy in ACLF [94]. Emerging therapies include therapy for circulatory dysfunction and correction of hyponatremia [95].…”

Section: Hepatic Encephalopathymentioning

confidence: 99%

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

et al. 2014

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The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. Due to the rapid advancements in the knowledge and available information, a consortium of members from countries across Asia Pacific, ''APASL ACLF Research Consortium (AARC),'' was formed in 2012. A large cohort of retrospective and prospective data of ACLF patients was collated and followed up in this data base. The current ACLF definition was reassessed based on the new AARC data base. These initiatives were concluded on a 2-day meeting in February 2014 at New Delhi and led to the development of the final AARC consensus. Only those statements which were based on the evidence and were unanimously recommended were accepted. These statements were circulated again to all the experts and subsequently presented at the annual conference of the APASL at Brisbane, on March 14, 2014. The suggestions from the delegates were analyzed by the expert panel, and the modifications in the consensus were made. The final consensus and guidelines document was prepared. After detailed deliberations and data analysis, the

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Section: Hepatic Encephalopathymentioning

confidence: 99%

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

et al. 2014

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“…HE patients have a significantly lower survival compared with patients without HE at all severities of liver disease [3,4]. Acute on chronic liver failure (ACLF) is a clinically and prognostically distinct syndrome that occurs in cirrhotic patients who are hospitalized with acute deterioration due to either known or unknown precipitating events, hepatic and/or extrahepatic organ failure and high short term mortality rates.…”

Section: Introductionmentioning

confidence: 99%

“…Pathophysiologically, the syndrome is characterized by altered host response to injury. One major recent finding is that HE in patients displaying a diagnosis of ACLF have higher mortality compared with HE patients without ACLF [3].…”

Section: Introductionmentioning

confidence: 99%

Modification in CSF specific gravity in acutely decompensated cirrhosis and acute on chronic liver failure independent of encephalopathy, evidences for an early blood-CSF barrier dysfunction in cirrhosis

et al. 2016

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“…A 2010 study of 170 cirrhotic patients from United States reported 56% of patients with underlying CHE, while 30% developed an episode of OHE [6] . Among 1348 consecutive patients with cirrhosis in a multi center European study, 34% patients were diagnosed with OHE [7] . Other studies utilizing data from British and Danish cohorts report OHE in 10% to 11% of patients in the setting of alcoholic cirrhosis [8,9] .…”

Section: Incidence and Prevalence Of Hementioning

confidence: 99%

Advances in cirrhosis: Optimizing the management of hepatic encephalopathy

Liu

Perumpail

Kumari

et al. 2015

WJH

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Hepatic encephalopathy (HE) is a major complication of cirrhosis resulting in significant socioeconomic burden, morbidity, and mortality. HE can be further subdivided into covert HE (CHE) and overt HE (OHE). CHE is a subclinical, less severe manifestation of HE and requires psychometric testing for diagnosis. Due to the time consuming screening process and lack of standardized diagnostic criteria, CHE is frequently underdiagnosed despite its recognized role as a precursor to OHE. Screening for CHE with the availability of the Stroop test has provided a pragmatic method to promptly diagnose CHE. Management of acute OHE involves institution of lactulose, the preferred first-line therapy. In addition, prompt recognition and treatment of precipitating factors is critical as it may result in complete resolution of acute episodes of OHE. Treatment goals include improvement of daily functioning, evaluation for liver transplantation, and prevention of OHE recurrence. For secondary prophylaxis, intolerance to indefinite lactulose therapy may lead to non-adherence and has been identified as a precipitating factor for recurrent OHE. Rifaximin is an effective add-on therapy to lactulose for treatment and prevention of recurrent OHE. Recent studies have demonstrated comparable efficacy of probiotic therapy to lactulose use in both primary prophylaxis and secondary prophylaxis.

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Characteristics, risk factors, and mortality of cirrhotic patients hospitalized for hepatic encephalopathy with and without acute-on-chronic liver failure (ACLF)

Cited by 277 publications

References 21 publications

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

Modification in CSF specific gravity in acutely decompensated cirrhosis and acute on chronic liver failure independent of encephalopathy, evidences for an early blood-CSF barrier dysfunction in cirrhosis

Advances in cirrhosis: Optimizing the management of hepatic encephalopathy

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