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Acute-on-chronic liver failure is independently associated with higher mortality for cirrhotic patients with acute esophageal variceal hemorrhage:Retrospective cohort study

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World Journal of Clinical Cases 2023年第17期11卷 4003-4018页

作者： Alana Zulian Terres Rafael Sartori Balbinot Ana Laura Facco Muscope Morgana Luisa Longen Bruna Schena Bruna Teston Cini Gilberto Luis Rost Jr Juline Isabel Leichtweis Balensiefer Louise Zanotto Eberhardt Raul Angelo Balbinot Silvana Sartori Balbinot Jonathan Soldera Clinical Gastroenterology Universidade de Caxias do SulCaxias do Sul 95020-002Brazil School of Medicine Universidade de Caxias do SulCaxias do Sul 95020-002Brazil Department of Gastroenterology University of South WalesCardiff CF371DLUnited Kingdom

BACKGROUND Acute esophageal variceal hemorrhage(AEVH)is a common complication of cirrhosis and might precipitate multi-organ failure,causing acute-on-chronic liver failure(ACLF).AIM To analyze if the presence and grading of ACLF as defined by European Society for the Study of the liver-chronic liver failure(EASL-CLIF)is able to predict mortality in cirrhotic patients presenting *** Retrospective cohort study executed in Hospital Geral de Caxias do *** from medical records from 2010 to 2016 were obtained by searching the hospital electronic database for patients who received *** records were reviewed in order to determine the diagnosis of cirrhosis and AEVH,including 97 ***-Meier survival analysis was used for univariate analysis and a stepwise approach to the Cox regression for multivariate *** All-cause mortality for AEVH patients was 36%,40.2%and 49.4%for 30-,90-and 365-day,*** prevalence of ACLF was 41.3%.Of these,35%grade 1,50%grade 2 and 15%grade *** multivariate analysis,the non-use of non-selective beta-blockers,presence and higher grading of ACLF and higher Model for End-Stage liver Disease scores were independently associated with higher mortality for 30-day with the addition of higher Child-Pugh scores for 90-day *** Presence and grading of ACLF according to the EASL-CLIF criteria was independently associated with higher 30-and 90-day mortality in cirrhotic patients admitted due to AEVH.

关键词： Gastrointestinal hemorrhage Prognosis Esophageal and gastric varices liver cirrhosis acuteon-chronic liver failure Organ dysfunction scores

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Prevalence and clinical characteristics of autoimmune liver disease in hospitalized patients with cirrhosis and acute decompensation in China

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World Journal of Gastroenterology 2022年第31期28卷 4417-4430页

作者： Zi-Xuan Shen Dan-Dan Wu Jie Xia Xian-Bo Wang Xin Zheng Yan Huang Bei-Ling Li Zhong-Ji Meng Yan-Hang Gao Zhi-Ping Qian Feng Liu Xiao-Bo Lu Jia Shang Hua-Dong Yan Yu-Bao Zheng Wen-Yi Gu Yan Zhang Jian-Yi Wei Wen-Ting Tan Yi-Xin Hou Qun Zhang Yan Xiong Cong-Cong Zou Jun Chen Ze-Bing Huang Xiu-Hua Jiang Sen Luo Yuan-Yuan Chen Na Gao Chun-Yan Liu Wei Yuan Xue Mei Jing Li Tao Li Xin-Yi Zhou Guo-Hong Deng Jin-Jun Chen Xiong Ma Hai Li Department of Gastroenterology Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Shanghai Institute of Digestive Disease Key Laboratory of Gastroenterology and HepatologyChinese Ministry of HealthShanghai Jiao Tong UniversityShanghai 200001China Department of Infectious Diseases Southwest HospitalThe Third Military Medical University(Army Medical University)Chongqing 400038China Center of Integrative Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100102China Department of Infectious Diseases Institute of Infection and ImmunologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina Department of Infectious Diseases Hunan Key Laboratory of Viral HepatitisXiangya HospitalCentral South UniversityChangsha 410008Hunan ProvinceChina Hepatology Unit Department of Infectious DiseasesNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Infectious Disease Taihe HospitalHubei University of MedicineShiyan 430418Hubei ProvinceChina Department of Hepatology The First Hospital of Jilin UniversityChangchun 130031Jilin ProvinceChina Department of liver Intensive Care Unit Shanghai Public Health Clinical CentreFudan UniversityShanghai 201508China Tianjin Institute of Hepatology Nankai University Second People’s HospitalTianjin 300102China Department of Infectious Diseases and Hepatology The Second Hospital of Shandong UniversityJinan 250033Shandong ProvinceChina Infectious Disease Center The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054XinjiangChina Department of Infectious Diseases Henan Provincial People’s HospitalZhengzhou 450003Henan ProvinceChina Department of Infectious Diseases Hwamei HospitalThe Second Hospital of NingboUniversity of Chinese Academy of SciencesNingbo 315153Zhejiang ProvinceChina Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 5

BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is *** To investigate the prevalence,outcome and risk factors for AILD in cirrhotic patients complicated with AD in *** We collected data from patients with cirrhosis and AD from two prospective,multicenter cohorts in hepatitis B virus endemic *** were regularly followed up at the end of 28-d,90-d and 365-d,or until death or liver transplantation(LT).The primary outcome in this study was 90-d LTfree ***-on-chronic liver failure(ACLF)was assessed on admission and during 28-d hospitalization,according to the diagnostic criteria of the European Association for the Study of the liver(EASL).Risk factors for death were analyzed with logistic regression *** In patients with cirrhosis and AD,the overall prevalence of AILD was 9.3%(242/2597).Prevalence of ACLF was significantly lower in AILD cases(14%)than those with all etiology groups with cirrhosis and AD(22.8%)(P<0.001).Among 242 enrolled AILD patients,the prevalence rates of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and PBC-AIH overlap syndrome(PBC/AIH)were 50.8%,28.5%and 12.0%,*** ACLF patients,the proportions of PBC,AIH and PBC/AIH were 41.2%,29.4% and 20.6%.28-d and 90-d mortality were 43.8% and 80.0% in AILD-related *** etiology of AILD had no significant impact on 28-d,90-d or 365-d LTfree mortality in patients with cirrhosis and AD in both univariate and multivariate *** bilirubin(TB),hepatic encephalopathy(HE)and blood urea nitrogen(BUN)were independent risk factors for 90-d LT-free mortality in multivariate *** development of ACLF during hospitalization only independently correlated to TB and international normalized *** AILD was not rare in hospitalized patients with cirrhosis and AD in China,among which PBC was the m

关键词： Prevalence Autoimmune liver disease Cirrhosis and acute decompensation Mortality acuteon-chronic liver failure

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Long-term albumin infusion in decompensated cirrhosis:A review of current literature

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World Journal of Hepatology 2021年第4期13卷 421-432页

作者： Yu Jun Wong Rahul Kumar Yu Jing Jonathan Chua Tiing Leong Ang Department ofGastroenterology and Hepatology Changi General HospitalSingapore 529889Singapore Department of Internal Medicine Yong Loo Lin School of MedicineSingapore 117597Singapore

Decompensated cirrhosis is characterized by chronic inflammation and severe portal hypertension leading to systemic circulatory *** infusion has been widely used in decompensated cirrhosis in patients with spontaneous bacterial peritonitis,large-volume paracentesis and hepatorenal *** data suggest long-term albumin infusion has both oncotic and non-oncotic properties which may improve the clinical outcomes in decompensated cirrhosis *** review the current literature on both the established and potential role of albumin,and specifically address the controversies of long-term albumin infusion in decompensated cirrhosis patients.

关键词： Albumin Cirrhosis Hepatic encephalopathy Hepatorenal syndrome acuteon-chronic liver failure Spontaneous bacterial peritonitis Large-volume paracentesis

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