Differential characteristics and prognosis of patients with hepatitis B virus‐related acute‐on‐chronic liver failure defined by European Association for the Study of the Liver – Chronic Liver Failure criteria

Wu, Juan; Li, Yuanyuan; Hu, Jinhua; Lin, Jianhao; Shi, Ming; Meng, Fanping; Li, Juan; Zhao, Juan; Wang, Fusheng; Meng, Qingying

doi:10.1111/hepr.12909

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…An accurate prognostic scoring system is necessary to estimate disease severity and accurately appoint ACLF patients to the appropriate management. Various prognostic models including the Model for End‐stage Liver Disease (MELD), MELD‐sodium (MELD‐Na), and Chronic Liver Failure‐Consortium (CLIF‐C) ACLF 9 score were deemed suitable to predict severity in ACLF patients with HBV etiology . Conversely, due to clinical discrepancies between Eastern and Western ACLF, these scores were found to be less sensitive for early diagnosis of HBV‐ACLF compared to the score recently proposed score by the Study of Severe Hepatitis B (COSSH) in China, which was constructed based on a large, multicenter cohort of HBV‐related ACLF patients.…”

Section: Introductionmentioning

confidence: 99%

A prognostic model for hepatitis B acute‐on‐chronic liver failure patients treated using a plasma exchange‐centered liver support system

Xie

Violetta

Chen

et al. 2019

J of Clinical Apheresis

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Aim: To determine the prognostic risk factors of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) treated with plasma exchange (PE)-based artificial liver support system (ALSS), and create a prognostic predictive model. Methods:A total of 304 HBV-ACLF patients who received PE-based ALSS were retrospectively analyzed. Potential prognostic factors on admission associated with survival were investigated. Of note, 101 additional patients were analyzed to validate the performance of the prognostic models.Results: According to 28-day survival, a total of 207 patients who survived and 97 non-survivors were identified in the derivation group. Overall, 268 (88.2%) ACLF cases were caused by reactivation of HBV. Cox proportional hazards regression model revealed that age, total bilirubin, ln (alphafetoprotein [AFP]), encephalopathy (HE) score, sodium level, and international normalized ratio (INR) were independent risk factors of short-term prognosis. We built a model named ALSS-prognosis model (APM) to predict the 28-day survival of HBV-ACLF patients with ALSS; the model APM showed potentially better predictive performance for both the derivation and validation groups than MELD, MELD-Na, and CLIF-C ACLF score.Conclusions: Low AFP was found to be an independent risk factor for high mortality in HBV-ACLF patients treated with PE-based ALSS. We generated a new model containing AFP, namely APM, which showed potentially better prediction performance than MELD, MELD-Na, and CLIF-C ACLF score for short-term outcomes, and could aid physicians in making optimal therapeutic decisions. K E Y W O R D S AFP, ALSS, HBV-ACLF, plasma exchange Zhongyang Xie and Laurencia Violetta contributed equally to this study.

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Section: Introductionmentioning

confidence: 99%

A prognostic model for hepatitis B acute‐on‐chronic liver failure patients treated using a plasma exchange‐centered liver support system

Xie

Violetta

Chen

et al. 2019

J of Clinical Apheresis

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“…These metabolites are considered to be common biomarkers of LF [32]. In addition, alpha-fetoprotein, serum sodium, lactate, arterial blood ammonia, and phosphate have been related to the prognosis of liver failure [18][19][20][21][22][23]. To date, very few studies have focused on the screening of potential serum therapeutic markers of LF patients treated by ALSSs.…”

Section: Discussionmentioning

confidence: 99%

“…They found that the levels of high-density lipoprotein and phosphorylcholine in patients with mild CLF were signi cantly higher than those in patients with severe CLF; and on the other hand, that the levels of lactate, pyruvate, glucose, amino acid, and creatinine were signi cantly higher in patients with severe CLF than in patients with mild liver failure [17]. Recent studies showed that alpha-fetoprotein, serum sodium, lactate, arterial blood ammonia, and phosphate were related to the prognosis of LF [18][19][20][21][22][23]. However, no study has yet focused on the screening of serum therapeutic markers of patients with liver failure who have been treated by ALSSs.…”

Section: Introductionmentioning

confidence: 99%

Serum Lactate:Creatinine Ratio as a Potential Therapeutic Markers of Liver Failure Patients Treated by Artificial Liver Support Systems

Sun

Chen

Zhou

et al. 2021

Preprint

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Artificial liver support systems (ALSSs) have been recommended as important approaches for treating liver fuilure (LF) patients. However, very few studies have focused on the screening of potential serum therapeutic markers of LF patients treated by ALSSs. Here, serum samples were obtained from 57 LF patients before and after ALSSs treatment and analyzed by metabonomics. The results showed that ratios of creatine:creatinine, taurine:creatinine, and lactate:creatinine were significantly altered and restored to normal levels after ALSSs treatment. The ratio of lactate:creatinine showed the highest area under a receiver-operating characteristic curve (AUROC) value (0.650), which was higher than that of the prothrombin time activity (PTA, 0.562). A retrospective analysis showed that serum lactate:creatinine ratios among the LF patient groups were 0.038 ± 0.002 (survival group, n=48), 0.048 ± 0.005 (three-month death group, n=24), and 0.052 ± 0.005 (one-month death group, n=33), which was significantly negatively correlated with survival (r= - 0.26). Another retrospective cohort analysis (n=81) of LF patients showed that the lactate-creatinine ratio in the death group remained unchanged, but fell markedly in the survival group (0.052 ± 0.005 vs. 0.025 ± 0.002) after ALSSs treatment. In comparison, the serum PTA levels were no statistical differences of in both the death group and survival group after ALSSs treatment. The AUROC of serum lactate-creatinine ratio and PTA after ALSSs treatment for diagnosis of survival group from death group was 0.682 and 0.591 respectively. These results indicate that the serum lactate-creatinine ratio may be more reliable than measures of PTA to evaluate the therapeutic effect of ALSSs treatment in LF patients.

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“…These metabolites are considered to be common biomarkers of liver failure [31]. In addition, alpha-fetoprotein, serum sodium, lactate, arterial blood ammonia, and phosphate have been related to the prognosis of liver failure [18][19][20][21][22][23]. To date, very few studies have focused on the screening of potential serum prognostic markers to predict the outcome for liver-failure patients treated by ALSSs.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum Lactate: Creatinine Ratio as a Prognostic Marker for Liver Failure Patients Treated by artificial liver support systems

Sun¹,

Chen²,

Zhou³

et al. 2020

Preprint

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Background: To screen potential serum prognostic markers for patients with liver failure treated by artificial liver support systems (ALSSs).Methods: Serum samples were obtained from 57 liver-failure patients before and after ALSSs therapy and analyzed by proton nuclear magnetic resonance. The diagnostic values were evaluated by calculation of the area under a receiver-operating characteristic curve (AUROC). Two retrospective analyses were further employed.Results: Metabonomics analysis showed that ratios of creatine:creatinine, taurine:creatinine, and lactate:creatinine were significantly altered and restored to normal levels after ALSSs treatment. The ratio of lactate:creatinine showed the highest AUROC value (0.650), which was higher than that of the prothrombin time activity (PTA, 0.562). A total of 105 cases of retrospective analysis showed that serum lactate:creatinine ratios among the liver-failure patients were 0.038 ± 0.002 (survival group, n=48), 0.048 ± 0.005 (three-month death group, n=24), and 0.052 ± 0.005 (one-month death group, n=33), which was significantly negatively correlated with survival (r= - 0.26). Another retrospective cohort analysis (n=81) of the early to middle stage liver-failure patients treated by ALSSs showed that the AUROC of the lactate:creatinine ratio for diagnosis of those who survived for one subsequent month was 0.827, which was higher than that of PTA (0.628) and lactate (0.765).Conclusion: The serum lactate:creatinine ratio may be a more sensitive measure than either the PTA or the lactate to evaluate the prognosis of ALSSs treatment in early to middle stage of liver-failure patients. This finding is worthy of further study in clinical applications.

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Differential characteristics and prognosis of patients with hepatitis B virus‐related acute‐on‐chronic liver failure defined by European Association for the Study of the Liver – Chronic Liver Failure criteria

Abstract: The EASL-CLIF ACLF classification can accurately prognosticate the short-term mortality of patients with HBV-related APASL ACLF. It can also distinguish distinct clinical characteristics and prognoses in patients with and without EASL-CLIF ACLF.

Cited by 6 publications

References 25 publications

A prognostic model for hepatitis B acute‐on‐chronic liver failure patients treated using a plasma exchange‐centered liver support system

A prognostic model for hepatitis B acute‐on‐chronic liver failure patients treated using a plasma exchange‐centered liver support system

Serum Lactate:Creatinine Ratio as a Potential Therapeutic Markers of Liver Failure Patients Treated by Artificial Liver Support Systems

Serum Lactate: Creatinine Ratio as a Prognostic Marker for Liver Failure Patients Treated by artificial liver support systems

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