Prognostic risk factors in patients with hepatitis B virus-related acute-on-chronic liver failure
10.3969/j.issn.1001-5256.2016.04.018
- VernacularTitle:乙型肝炎相关慢加急性肝衰竭患者预后的危险因素分析
- Author:
Xinxing SHI
1
;
Yanqiong ZHANG
;
Peng ZHU
Author Information
1. Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
- Publication Type:Research Article
- Keywords:
liver failure;
hepatitis B virus;
risk factors;
prognosis
- From:
Journal of Clinical Hepatology
2016;32(4):700-705
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the clinical characteristic and long-term prognosis risk factor of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF). MethodsThe clinical data of 1116 HBV-ACLF patients who were hospitalized in Southwest Hospital of Third Military Medical University from January 2010 to January 2015 were analyzed retrospectively. The risk factors for 1-year survival time and prognosis were observed, and the Cox regression model was used to determine the independent risk factors for the prognosis of these patients. The t-test or t′-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. ResultsA total of 562 patients died within the 1-year follow-up period, and the fatality rate was 50.4%. The comparison between the survival group and the death group showed that age, alanine aminotransferase, total bilirubin, urea nitrogen, serum creatinine, international normalized ratio, serum Na+, white blood cell (WBC), percentage of neutrophils, platelet (PLT), HBV DNA load, Model for End-Stage Liver Disease (MELD) score, ascites, spontaneous bacterial peritonitis, gastrointestinal bleeding, pulmonary infection, sepsis, electrolyte disturbance, hepatic encephalopathy, and acute kidney injury (AKI) were the risk factors for death within 1 year (all P＜0.05). The Cox regression analysis showed that age, WBC, MELD score, hepatic encephalopathy, electrolyte disturbance, AKI, and PLT were the independent risk factors for the 1-year fatality in HBV-ACLF patients (all P＜005). ConclusionOur findings show that HBV-ACLF has a high fatality rate and is often accompanied by serious complications. The major risk factors affecting the 1-year fatality in HBV-ACLF patients are age, WBC, MELD score, hepatic encephalopathy, electrolyte disturbance, AKI, and PLT.
