Predictive factors for 28-day mortality in acute-on-chronic liver failure patients admitted to the intensive care unit.

da Silva Boteon, Amanda Pinter Carvalheiro, Chauhan, Abhishek, Boteon, Yuri Longatto, Tillakaratne, Suchintha, Gunson, Bridget K, Elsharkawy, Ahmed Mohamed, Ford, Abby, Bangash, Mansoor, Murphy, Nick, Armstrong, Matthew J, Rajoriya, Neil and Perera, M Thamara P R (2019) Predictive factors for 28-day mortality in acute-on-chronic liver failure patients admitted to the intensive care unit. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. ISSN 1878-3562. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

Full text not available from this repository.
Official URL: https://www.dldjournalonline.com/article/S1590-865...

Abstract

BACKGROUND

Acute-on-chronic liver failure (ACLF) is an entity comprising an acute deterioration of liver function in cirrhotic patients, associated with organ failure(s) and high short-term mortality. We aimed to identify predictive factors for short-term mortality in patients admitted with ACLF that may benefit most from liver transplantation.

METHODS

Retrospective analysis of patients admitted in ACLF to a tertiary intensive care unit between 2013 and 2017 was performed. The EASL-CLIF acute-on-chronic liver failure in cirrhosis (CANONIC) criteria were used to define ACLF grade. Multivariable analysis using 28-day mortality as an end-point was performed, including severity-of-disease scores and clinical parameters.

RESULTS

Seventy-seven patients were admitted in ACLF over the study period. The commonest aetiology of liver disease was alcohol related 52/77(68%) and the commonest precipitant of ACLF was variceal haemorrhage 38/77(49%). Overall 28-day mortality was 42/77(55%) [ACLF-(grade)1:3/42(7%); ACLF-2:10/42(24%); and, ACLF-3:29/42(69%);p = 0.002]. On multivariable analysis MELD ≥ 26 [odds ratio(OR) = 11.559; 95% confidence interval(CI):2.820-47.382;p = 0.001], ACLF-3 (OR = 3.287; 95%CI:1.047-10.325;p = 0.042) at admission and requirement for renal replacement therapy (OR = 5.348; 95%CI:1.385-20.645;p = 0.015) were independently associated with 28-day mortality.

CONCLUSION

Patients admitted with ACLF to intensive care have a high mortality rate. Defined early thresholds at admission can identify patients at the highest risk that may benefit most from liver transplantation.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
WJ Urogenital system. Urology
Divisions: Emergency Services > Renal
Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 15 May 2019 08:55
Last Modified: 15 May 2019 08:55
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2102

Actions (login required)

View Item View Item