Characterization of Acute-on-chronic Liver Diseases: A Multicenter Prospective Cohort Study

Overview

Journal World J Hepatol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2024 May 31

PMID 38818287

Authors

Yuan-Yao Zhang

Sen Luo

Hai Li

Shu-Ning Sun

Xian-Bo Wang

Xin Zheng

Yan Huang

Bei-Ling Li

Yan-Hang Gao

Zhi-Ping Qian

Feng Liu

Xiao-Bo Lu

Jun-Ping Liu

Hao-Tang Ren

Yu-Bao Zheng

Hua-Dong Yan

Guo-Hong Deng

Liang Qiao

Yan Zhang

Wen-Yi Gu

Xiao-Mei Xiang

Yi Zhou

Yi-Xin Hou

Qun Zhang

Yan Xiong

Cong-Cong Zou

Jun Chen

Ze-Bing Huang

Xiu-Hua Jiang

Ting-Ting Qi

Yuan-Yuan Chen

Na Gao

Chun-Yan Liu

Wei Yuan

Xue Mei

Jing Li

Tao Li

Rong-Jiong Zheng

Xin-Yi Zhou

Jun Zhao

Zhong-Ji Meng

Affiliations

Soon will be listed here.

Abstract

Background: Acute-on-chronic liver disease (AoCLD) accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.

Aim: To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of AoCLD.

Methods: Patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure (ACLF) study cohort were included in this study. The clinical characteristics and outcomes, and the 90-d survival rate associated with each clinical type of AoCLD were analyzed, using the Kaplan-Meier method and the log-rank test.

Results: A total of 3375 patients with AoCLD were enrolled, including 1679 (49.7%) patients with liver cirrhosis acute decompensation (LC-AD), 850 (25.2%) patients with ACLF, 577 (17.1%) patients with chronic hepatitis acute exacerbation (CHAE), and 269 (8.0%) patients with liver cirrhosis active phase (LC-A). The most common cause of chronic liver disease (CLD) was HBV infection (71.4%). The most common precipitants of AoCLD was bacterial infection (22.8%). The 90-d mortality rates of each clinical subtype of AoCLD were 43.4% (232/535) for type-C ACLF, 36.0% (36/100) for type-B ACLF, 27.0% (58/215) for type-A ACLF, 9.0% (151/1679) for LC-AD, 3.0% (8/269) for LC-A, and 1.2% (7/577) for CHAE.

Conclusion: HBV infection is the main cause of CLD, and bacterial infection is the main precipitant of AoCLD. The most common clinical type of AoCLD is LC-AD. Early diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.

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