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Cited 39 time in webofscience Cited 43 time in scopus
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Characteristics and Discrepancies in Acute-on-Chronic Liver Failure: Need for a Unified Definitionopen access

Authors
Kim, Tae YeobSong, Do SeonKim, Hee YeonSinn, Dong HyunYoon, Eileen L.Kim, Chang WookJung, Young KulSuk, Ki TaeLee, Sang SooLee, Chang HyeongKim, Tae HunKim, Jeong HanChoe, Won HyeokYim, Hyung JoonKim, Sung EunBaik, Soon KooLee, Byung SeokJang, Jae YoungSuh, Jeong IllKim, Hyoung SuNam, Seong WooKwon, Hyeok ChoonKim, Young SeokKim, Sang GyuneChae, Hee BokYang, Jin MoSohn, Joo HyunLee, Heon JuPark, Seung HaHan, Byung HoonChoi, Eun HeeKim, Chang H.Kim, Dong Joon
Issue Date
20-Jan-2016
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v.11, no.1
Indexed
SCIE
SCOPUS
Journal Title
PLOS ONE
Volume
11
Number
1
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/6807
DOI
10.1371/journal.pone.0146745
ISSN
1932-6203
Abstract
Background & Aim To investigate the prevalence, mortalities, and patient characteristics of Acute-on-chronic liver failure (ACLF) according to the AARC (Asian Pacific Association for the Study of the Liver ACLF Research Consortium) and European Association for the Study of the Liver CLIF-C (Chronic Liver Failure Consortium) definitions. Methods We collected retrospective data for 1470 hospitalized patients with chronic liver disease (CLD) and acute deterioration between January 2013 and December 2013 from 21 university hospitals in Korea. Results Of the patients assessed, the prevalence of ACLF based on the AARC and CLIF-C definitions was 9.5% and 18.6%, respectively. The 28-day and 90-day mortality rates were higher in patients with ACLF than in those without ACLF. Patients who only met the CLIF-C definition had significantly lower 28-day and 90-day survival rates than those who only met the AARC definition (68.0% vs. 93.9%, P<0.001; 55.1% vs. 92.4%, P<0.001). Among the patients who had non-cirrhotic CLD, the 90-day mortality of the patients with ACLF was higher than of those without ACLF, although not significant (33.3% vs. 6.0%, P = 0.192). Patients with previous acute decompensation (AD) within 1-year had a lower 90-day survival rate than those with AD more than 1 year prior or without previous AD (81.0% vs. 91.9% or 89.4%, respectively, all P<0.001). Patients who had extra-hepatic organ failure without liver failure had a similar 90-day survival rate to those who had liver failure as a prerequisite (57.0% vs. 60.6%, P = 0.391). Conclusions The two ACLF definitions result in differences in mortality and patient characteristics among ACLF patients. We suggest that non-cirrhotic CLD, previous AD within 1 year, and extrahepatic organ failure should be included in the ACLF diagnostic criteria. In addition, further studies are necessary to develop a universal definition of ACLF.
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Jung, Young Kul
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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