Clinical Course and Outcome Patterns of Acute-on-chronic Liver Failure:A Multicenter Retrospective Cohort Study
作者机构：Fourth Department of Liver Disease(Difficult&Complicated Liver Diseases and Artificial Liver Center)Beijing You’an Hospital Affiliated to Capital Medical UniversityBeijingChina Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment ResearchBeijingChina Department of HepatologyThe Third Central Clinical College of Tianjin Medical UniversityTianjinChina Liver Failure Treatment and Research CenterThe Fifth Medical Center of Chinese PLA General HospitalBeijingChina Department of General SurgeryBeijing You’an Hospital Affiliated to Capital Medical UniversityBeijingChina
出 版 物：《Journal of Clinical and Translational Hepatology》 (临床与转化肝病杂志（英文版）)
年 卷 期：2021年第9卷第5期
页 面：626-634页
核心收录：
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
基 金：This study was supported by the National 13th 5-Year Plan for Hepatitis Research(Grant No.2017ZX10203201-005,2017ZX10203201-007) National Key R&D Program of China(Grant No.2017YFA0103000) Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(Grant No.ZYLX201806) the National Natural Science Foundation of China(Grant No.81870429) Capital Clinic Characteristic Application Research(Grant No.Z181100001718143)
主 题：Acute-on-chronic liver failure Clinical course Outcome patterns Retrospective cohort study
摘 要：Background and Aims:Acute-on-chronic liver failure(ACLF)is acute decompensation of liver function in the setting of chronic liver disease,and characterized by high short-term *** this study,we sought to investigate the clinical course of patients at specific time points,and to propose dynamic prognostic ***:We assessed the clinical course of 453 patients with ACLF during a 12-week follow-up period in this retrospective multicenter *** clinical course of patients was defined as disease recovery,improvement,worsening or steady patterns based on the variation tendency in prothrombin activity(PTA)and total bilirubin(TB)at different time ***:Resolution of PTA was observed in 231 patients(51%)at 12 weeks after the diagnosis of *** the remaining patients,66(14.6%)showed improvement and 156(34.4%)showed a steady or worsening *** patients with resolved PTA,the clinical course of TB exhibited resolved pattern in 95.2%,improved in 3.9%,and steady or worse in 0.8%.Correspondingly,in patients with improved PTA,these values for TB were 28.8%,27.3%,and 43.9%,*** patients with steady or worsening PTA,these values for TB were 5.7%,32.3%,and 65.6%,*** prognostic criteria were developed by combining the clinical course of PTA/TB and the clinical outcomes at 4 and 12 weeks after diagnosis in ACLF ***:We propose the following dynamic prognostic criteria:rapid progression,slow progression,rapid recovery,slow recovery,and slow persistence,which lay the foundation for precise prediction of prognosis and the improvement of ACLF therapy.
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