Details

Autor(en) / Beteiligte

• Fan, Hsiu-Lung
• Yang, Po-Sheng
• Chen, Hui-Wei
• Chen, Teng-Wei
• Chan, De-Chuan
• Chu, Chi-Hong
• Yu, Jyh-Cherng
• Kuo, Shih-Ming
• Hsieh, Chung-Bao

Titel

Predictors of the outcomes of acute-on-chronic hepatitis B liver failure

Ist Teil von

• World journal of gastroenterology : WJG, 2012-09, Vol.18 (36), p.5078-5083

Ort / Verlag

United States: Baishideng Publishing Group Co., Limited

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• AIM： To identify the risk factors in predicting the out- come of acute-on-chronic hepatitis B liver failure pa- tients. METHODS： We retrospectively divided 113 patients with acute-on-chronic liver failure-hepatitis B virus （ACLF-HBV） and without concurrent hepatitis C or D virus infection and hepatocellular carcinoma into two groups according to their outcomes after anti-HBV therapy. Their demographic, clinical, and biochemical data on the day of diagnosis and after the first week of treatment were analyzed using the Mann-Whitney U test, Fisher＇s exact test, and a multiple logistic regres- sion analysis. RESULTS： The study included 113 patients （87 men and 26 women） with a mean age of 49.84 years. Fifty- two patients survived, and 61 patients died. Liver failure （85.2%）, sepsis （34.4%）, and multiple organ failure （39.3%） were the main causes of death. Mul- tivariate analyses showed that Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ scores ≥ 12 [odds ratio （OR） = 7.160, 95% CI： 2.834-18.092, P 〈 0.001] and positive blood culture （OR = 13.520, 95% CI： 2.740-66.721, P = 0.001） on the day of diagnosis and model for end-stage liver disease （MELD） scores 28 （OR = 8.182, 95% CI： 1.884-35.527, P = 0.005） after the first week of treatment were independent predictors of mortality. CONCLUSION： APACHE II scores on the day of diag- nosis and MELD scores after the first week of anti-HBV therapy are feasible predictors of outcome in ACLF- HBV patients.