Etiology, clinical profile, and inhospital mortality of acute-on-chronic liver failure: a prospective study

Jha, Ashish K.; Nijhawan, Sandeep; Roop, Ramesh; Nepalia, Subhash; Jain, Pankaj; Suchismita, Arya

doi:10.1007/s12664-012-0295-9

Cited by 30 publications

(28 citation statements)

References 34 publications

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“…Approximately 42% (415) of patients had creatinine > 1.5 mg/dL. The median CTP and MELD scores were 12 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and 27 (6-40), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…There is paucity of data from India; most studies are single-center with small sample size. [4][5][6][7][8][9][10][11][12][13] Therefore, the Indian National Association for Study of the Liver (INASL) formed the INASL Consortium for ACLF Research in the East (ICARE) that included 10 tertiary care centers from all parts of India and planned the present study to assess etiologies, course, and outcomes of patients with ACLF seen across India.…”

Section: Introductionmentioning

confidence: 99%

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Acute‐on‐chronic liver failure in India: The Indian National Association for Study of the Liver consortium experience

Shalimar¹,

Saraswat

Singh

et al. 2016

J of Gastro and Hepatol

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“…Approximately 42% (415) of patients had creatinine > 1.5 mg/dL. The median CTP and MELD scores were 12 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and 27 (6-40), respectively.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute‐on‐chronic liver failure in India: The Indian National Association for Study of the Liver consortium experience

Shalimar¹,

Saraswat

Singh

et al. 2016

J of Gastro and Hepatol

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“…Experts reviewed the data from the AARC, and the etiologic profile of cirrhosis in ACLF was found to be similar to the etiology of cirrhosis in general in the respective countries [26,46,47]. With the rising incidence of obesity and NAFLD, proportion of burnt-out NASH presenting as cryptogenic cirrhosis is also increasing [48][49][50].…”

Section: Defining the Underlying Chronic Liver Diseasementioning

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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“…17 Subsequently, many publications have reported HEV as one of the leading causes for decompensation of cirrhosis from Asia and Africa, where HEV is endemic (Table 1). 14,15,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Most of these studies have used the APASL definition of ACLF and in median21% of cases (range 4-72%) of ACLF, HEV was the precipitating cause for liver decompensation. This contrasts with the Western countries where HEV is rarely the precipitating cause of acute decompensation in ACLF.…”

Section: Role Of Hepatitis E Virus In Acute-on-chronic Liver Failurementioning

confidence: 99%

Hepatitis E and Acute-on-Chronic Liver Failure

Kumar

Saraswat

2013

Journal of Clinical and Experimental Hepatology

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Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis (AVH) globally. It causes large scale epidemics of AVH across the low-and middle income countries in Asia and Africa, and also causes sporadic cases of AVH in the same geographical region. AVH due to HEV is usually an acute, self-limiting illness, similar in clinical presentation to AVH caused by hepatitis A virus (HAV). When HEV causes AVH in patients of chronic liver disease it may worsen rapidly to a syndrome called acute-on-chronic liver failure (ACLF) leading to very high mortality. Acute deterioration of liver function in a patient with compensated chronic liver disease is the characteristic feature of ACLF. The typical disease course of patients with ACLF is the appearance of organ failure, which progresses to multi-organ failure and death. Many publications have reported HEV as one of the leading causes for ACLF from Asia and Africa, where HEV is endemic. The mortality rate of HEV-related ACLF (HEV-ACLF) ranges from 0% to 67% with a median being 34%. These patients require admission in the intensive care unit and they benefit from a team approach of clinicians with expertise in both hepatology and critical care. The goals of treatment are to prevent further deterioration in liver function, reverse precipitating factors, and support failing organs. Liver transplantation is required in selected patients to improve survival and quality of life. One preliminary report suggests that ribavirin may be an effective and safe drug for treatment of HEV-ACLF however this requires validation in large trials. ( J CLIN EXP HEPATOL 2013;3:225-230)

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Etiology, clinical profile, and inhospital mortality of acute-on-chronic liver failure: a prospective study

Abstract: Hepatitis virus and bacterial infection/sepsis were the common acute insults in ACLF. Dual acute insult is not uncommon, poses diagnostic dilemma, and may increase mortality in these patients. Plasmodium falciparum infection and dengue fever may be associated with ACLF.

Cited by 30 publications

References 34 publications

Acute‐on‐chronic liver failure in India: The Indian National Association for Study of the Liver consortium experience

Acute‐on‐chronic liver failure in India: The Indian National Association for Study of the Liver consortium experience

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

Hepatitis E and Acute-on-Chronic Liver Failure

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