单位：[1]Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Thai Red Cross, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Pathumwan, Bangkok, Thailand中山大学附属第二医院[2]Liver Fibrosis and Cirrhosis Research Unit, Chulalongkorn University, Bangkok, Thailand[3]Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India[4]IMS &SUM Hospital, Bhubaneswar, Odisha, India[5]Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India[6]Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India[7]EF Clif, EASL-CLIF Consortium and Grifols Chair, Barcelona, Spain[8]Inserm, U1149, Centre de Recherche Sur L’Infammation (CRI),, Paris, France[9]UMRS1149, Université de Paris, Paris, France[10]Service d’Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France[11]Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh[12]PGIMER, Chandigarh, India[13]St John’s Medical College, Bangalore, India[14]Beijing Youan Hospital and Translational Hepatology Institute, Beijing, China[15]Tongji Hospital, Tongji Medical College, Wuhan, China华中科技大学同济医学院附属同济医院[16]Department of Gastroenterology, Bombay Hospital and Medical Research Centre, Mumbai, India[17]CMC, Vellore, India[18]Aga Khan University Hospital, Karachi, Pakistan[19]Hallym University College of Medicine, Chuncheon, South Korea[20]Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore[21]Dayanand Medical College, Ludhiana, India[22]Digestive Disease & Oncology Centers, Medistra Hospital, Jakarta, Indonesia[23]Ziauddin University, Karachi, Pakistan[24]Egyptian Liver Research Institute and Hospital, Cairo, Egypt[25]Cardinal Santos Medical Center, San Jaun, Philippines[26]Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong[27]Department of Medicine, Humanity and Health Medical Group, New Kowloon, Hongkong, China[28]Friendship Hospital, Capital University, Beijing, China首都医科大学附属北京友谊医院[29]Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Acharya Shree Tulsi Marg, Vasant Kunj, New Delhi 110070, India[30]Department of Advanced Endoscopy, Institute of Liver and Biliary Sciences, D-1, Acharya Shree Tulsi Marg, Vasant Kunj, New Delhi 110070, India[31]Chiba University, Chiba, Japan[32]Institute of Liver and Biliary Sciences, New Delhi, India
Background and aims Acute-on-chronic liver failure (ACLF) is considered a main prognostic event in patients with chronic liver disease (CLD). We analyzed the 28-day and 90-day mortality in ACLF patients with or without underlying cirrhosis enrolled in the ACLF Research Consortium (AARC) database. Methods A total of 1,621 patients were prospectively enrolled and 637 (39.3%) of these patients had cirrhosis. Baseline characteristics, complications and mortality were compared between patients with and without cirrhosis. Results Alcohol consumption was more common in cirrhosis than non-cirrhosis (66.4% vs. 44.2%, p < 0.0001), while non-alcoholic fatty liver disease/cryptogenic CLD (10.9% vs 5.8%, p < 0.0001) and chronic HBV reactivation (18.8% vs 11.8%, p < 0.0001) were more common in non-cirrhosis. Only 0.8% of patients underwent liver transplantation. Overall, 28-day and 90-day mortality rates were 39.3% and 49.9%, respectively. Patients with cirrhosis had a greater chance of survival compared to those without cirrhosis both at 28-day (HR = 0.48; 95% CI 0.36-0.63, p < 0.0001) and 90-day (HR = 0.56; 95% CI 0.43-0.72, p < 0.0001), respectively. In alcohol CLD, non-cirrhosis patients had a higher 28-day (49.9% vs. 23.6%, p < 0.001) and 90-day (58.4% vs. 35.2%, p < 0.001) mortality rate than cirrhosis patients. ACLF patients with cirrhosis had longer mean survival than non-cirrhosis patients (25.5 vs. 18.8 days at 28-day and 65.2 vs. 41.2 days at 90-day). Exaggerated systemic inflammation might be the reason why non-cirrhosis patients had a poorer prognosis than those with cirrhosis after ACLF had occurred. Conclusions The 28-day and 90-day mortality rates of ACLF patients without cirrhosis were significantly higher than those with cirrhosis in alcoholic CLD. The presence of cirrhosis and its stage should be evaluated at baseline to guide for management. Thai Clinical Trials Registry, TCTR20191226002.
基金：
Ratchadaphiseksomphot Endowment Fund of hepatic fibrosis and cirrhosis research unit, Chulalongkorn University [GRU 6105530009-1]; Liver Research Unit of the Faculty of Medicine, Chulalongkorn University (Prof. Sombat Treeprasertsuk); Fatty Liver Unit, Division of Gastroenterology
第一作者单位：[1]Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Thai Red Cross, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Pathumwan, Bangkok, Thailand[2]Liver Fibrosis and Cirrhosis Research Unit, Chulalongkorn University, Bangkok, Thailand
通讯作者：
推荐引用方式(GB/T 7714)：
Kessarin Thanapirom,Tongluk Teerasarntipan,Sombat Treeprasertsuk,et al.Impact of compensated cirrhosis on survival in patients with acute-on-chronic liver failure[J].HEPATOLOGY INTERNATIONAL.2022,16(1):171-182.doi:10.1007/s12072-021-10266-8.
APA：
Kessarin Thanapirom,Tongluk Teerasarntipan,Sombat Treeprasertsuk,Ashok Choudhury,Manoj K. Sahu...&Shiv Kumar Sarin.(2022).Impact of compensated cirrhosis on survival in patients with acute-on-chronic liver failure.HEPATOLOGY INTERNATIONAL,16,(1)
MLA：
Kessarin Thanapirom,et al."Impact of compensated cirrhosis on survival in patients with acute-on-chronic liver failure".HEPATOLOGY INTERNATIONAL 16..1(2022):171-182
医学