Clinical profile, natural history, and predictors of mortality in patients with acute-on-chronic liver failure (ACLF)

Mikolašević, Ivana; Milić, Sandra; Radić, Mladen; Orlić, Lidija; Bagić, Željka; Stimac, Davor

doi:10.1007/s00508-015-0707-9

Cited by 17 publications

(22 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, approximately a half of the patients had a lethal outcome and the 28-day mortality was 37.5%, indicating that ACLF patients have a very high short-term morality rate. Previous studies have also demonstrated that ACLF is a serious and challenging condition with a very high short-term mortality [2,[6][7][8][9] The mean age in our cohort was 60.1 ± 9.9, which is similar to the previous study of Mikolašević et al [7], but different from the study of Dhiman et al [18], where the mean age was 46 ± 13 years. We can explain the differences by the large number of patients with ALD, where the onset of the disease was usually at an older age.…”

Section: Prognostic Scoressupporting

confidence: 67%

“…The joint American Association for the Study of Liver Disease and European Association for the Study of the Liver (AASLD/EASL) identifies ACLF as a syndrome with a high mortality rate, which includes the subgroup of cirrhotic patients who develop organ failure, with/without an identifiable precipitating event, such as variceal bleeding, acute alcoholism or infection [1,5]. Researchers from the EASL -Chronic Liver Failure Consortium (CLIF) prospectively studied patients with chronic liver disease (CLD) and AD, and found that patients with AD who had organ failure and high 28-day mortality rates, could be diagnosed with ACLF [1,2,6,7]. Due to a very high risk of mortality, ACLF patients require early identification and intensive treatment [7,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Researchers from the EASL -Chronic Liver Failure Consortium (CLIF) prospectively studied patients with chronic liver disease (CLD) and AD, and found that patients with AD who had organ failure and high 28-day mortality rates, could be diagnosed with ACLF [1,2,6,7]. Due to a very high risk of mortality, ACLF patients require early identification and intensive treatment [7,8,9]. Mortality in patients with two organ failures goes up to 32%, and rises to approximately 80% if three or more organ systems fail [10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of treatment outcome in patients with acute-on-chronic liver failure using clinical scores

Milovanović

Lalosevic²,

Dragašević

et al. 2020

Srp Arh Celok Lek

View full text Add to dashboard Cite

Introduction/Objective Due to a very high mortality risk, acute-on-chronic liver failure (ACLF) patients require early identification and intensive treatment. Precise prediction is crucial for determining the urgency degree and therapy appropriateness, considering high mortality and multitude of clinical resources. The aim of our study was to determine the exact cutoff values of various prognostic scores in the prediction of morality of ACLF. Methods This prospective study includes chronic liver disease (CLD) patients, admitted due to decompensation, that were subsequently diagnosed with ACLF at the Emergency unit. All patients were evaluated based on various prognostic scores, including Child-Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C, which were calculated on admission. Results Alcoholic liver disease (ALD) was the most common underlying CLD cause (77.9%), followed by viral (8.6%), autoimmune (7.7%), and other causes (5.8%). A total of 37.5% of the patients died at the end of the first month of treatment. Average values of Child-Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C scores were significantly higher in patients who died compared to survivors (p < 0.05). CLIF C score showed the best performance with a cutoff value of 50.5, with a sensitivity of 94.9% and specificity of 40%. Conclusion ACLF remains a condition with a high short-term mortality. Of all of the scores examined in our study, CLIF C proved to be the best scoring system for predicting short term and end of treatment mortality in patients with ACLF.

show abstract

Section: Prognostic Scoressupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of treatment outcome in patients with acute-on-chronic liver failure using clinical scores

Milovanović

Lalosevic²,

Dragašević

et al. 2020

Srp Arh Celok Lek

View full text Add to dashboard Cite

show abstract

“…In different phase, patients undergo various pathophysiology [2]. In advanced phase, immune damage and hypoxic-ischemic damage may be dominant [3].…”

mentioning

confidence: 99%

The Association between Expression of NK Cells and Prognosis of Patients with HBV Acute-on-Chronic Liver Failure in Advanced Phase

Weng¹,

Shi²,

Peng³

et al. 2017

AID

View full text Add to dashboard Cite

Acute-on-chronic liver failure (Acute-on-chronic liver failure, ACLF) is acute liver function decompensation on the basis of chronic liver disease. The progression of ACLF develops from advanced phase, plateau phase to remission phase. The pathophysiological basis of ACLF in different phases is various. In advanced phase, immune imbalance and systemic inflammatory reaction plays key roles. In this study, we try to assess the association between expression of NK cells and its receptors and prognosis of patients with ACLF in advanced phase. A total of 35 inpatients with HBV acute-on-chronic liver failure in advanced phase were recruited. They were divided into case group (n = 18) and control group (n = 17) according to whether the patients was dead in the 12 weeks. PBMC were detected for the frequency and expression of NK cell receptors by flow cytometric analysis. Our results demonstrated that patients who died had lower expression of NK cells and inhibitory receptor KIR3DL1, higher levels of FASL. During 12-week follow-up in those case alive, we found that NK cells increased, while expression of FASL decreased. High short-term mortality of ALCF was associated with NK cell, especially related to KIR3DL1 and FASL (P NK = 0.036, P KIR3DL1 = 0.0265, P FasL = 0.0008).

show abstract

“…Another observational study indicated that the presence of SIRS on admission was associated with in-hospital mortality in patients with acute-on-chronic liver failure (8). In cirrhotic patients, SIRS is associated with portal hypertension-related complications, poor hospital outcomes, and mortality.…”

mentioning

confidence: 99%

Effect of SIRS and sepsis on mortality in alcoholic hepatitis: A systematic review and meta-analysis

Jaruvongvanich¹,

Sanguankeo²,

Upala³

2016

Turk J Gastroenterol

View full text Add to dashboard Cite

Clinical profile, natural history, and predictors of mortality in patients with acute-on-chronic liver failure (ACLF)

Abstract: ACLF is a serious condition with high short-term mortality. Because ACLF is reversible, it is necessary to identify at-risk patients as soon as possible to treat acute events in a timely manner.

Cited by 17 publications

References 27 publications

Evaluation of treatment outcome in patients with acute-on-chronic liver failure using clinical scores

Evaluation of treatment outcome in patients with acute-on-chronic liver failure using clinical scores

The Association between Expression of NK Cells and Prognosis of Patients with HBV Acute-on-Chronic Liver Failure in Advanced Phase

Effect of SIRS and sepsis on mortality in alcoholic hepatitis: A systematic review and meta-analysis

Contact Info

Product

Resources

About