■本研究计划评估病因,当然,慢性急性肝衰竭(ACLF)患者的预后。
■符合改良的2009年亚太肝脏共识研究协会标准的ACLF患者(182名男性和26名女性)被SMS医学院和医院消化内科收治,斋浦尔,包括2015年10月至2017年12月。我们评估了基础慢性疾病的病因和急性事件导致ACLF失代偿。
■慢性肝病(CLD)的最常见病因是酒精,有133例(63.94%)患者。病毒性肝炎,隐源性肝硬化,自身免疫,非酒精性脂肪性肝炎,32例(15.4%)中存在作为CLD原因的威尔逊病,29(13.94%),9(4.3%),3(1.4%),和2例(1%),分别。酒精,脓毒症,出血,乙型肝炎的再激活,戊型肝炎,抗结核药物,和自身免疫性肝炎作为急性事件的原因存在于100(48.08%),34(16.35%),19(9.1%),17(8.2%),15(7.2%),13(6.25%),和2名(0.96%)患者,分别。在8例(3.85%)患者中,沉淀事件无法得知。在这项研究中,死亡率(住院)为37.5%。更高的终末期肝病模型评分和高Child-Turcotte-Pugh评分与死亡率显着相关(P<0.001)。ACLF分级较高的患者死亡率较高。酒精作为CLD的原因与死亡率显着相关(p=0.0146,95%置信区间在3.802和30.979之间)。幸存者和非幸存者之间的急性沉淀事件没有显着差异。
■酒精是慢性病因和急性诱发事件的最常见原因。酒精作为CLD的原因与死亡率显著相关。
UNASSIGNED: The present study is planned to assess etiologies, course, and outcome in patients with acute-on-chronic liver failure (ACLF).
UNASSIGNED: Two hundred and eight (182 males and 26 females) patients of ACLF fulfilling modified Asia Pacific Association For Study Of Liver Consensus criteria 2009 admitted to the gastroenterology department of SMS Medical College and hospital, Jaipur, between October 2015 and December 2017 were included. We evaluated etiology of underlying chronic disease and the acute event precipitating decompensation in ACLF.
UNASSIGNED: Most common etiology of chronic liver disease (CLD) was alcohol with 133 (63.94 %) patients. Viral hepatitis, cryptogenic cirrhosis, autoimmunity, nonalcoholic steatohepatitis, and Wilson disease as causes of CLD were present in 32 (15.4%), 29 (13.94%), 9 (4.3%), 3 (1.4%), and 2 (1%) cases, respectively. Alcohol, sepsis, bleeding, reactivation of hepatitis B, hepatitis E, antitubercular drugs, and autoimmune hepatitis as the causes of acute event were present in 100 (48.08%), 34 (16.35%), 19 (9.1%), 17 (8.2 %), 15 (7.2%), 13 (6.25%), and 2 (0.96%) patients, respectively. In 8 (3.85%) patients, the precipitating event could not be known. Mortality (in-hospital) in this study was 37.5%. Higher model for end-stage liver disease score and high Child-Turcotte-Pugh score score were significantly associated with mortality (P <0.001). Patients with higher ACLF grade were associated with higher mortality. Alcohol as a cause of CLD was significantly associated with mortality (p=0.0146, 95% confidence interval between 3.802 and 30.979). There was no significant difference regarding acute precipitating events between survivors and nonsurvivors.
UNASSIGNED: Alcohol was the most common cause for chronic etiology as well as acute precipitating event. Alcohol as a cause of CLD was significantly associated with mortality.