Value of serum tryptophan in stratified management of 90-day mortality risk in patients with hepatitis B virus-related acute-on-chronic liver failure: a multicenter retrospective study.
10.12122/j.issn.1673-4254.2025.01.08
- Author:
Chao ZHOU
1
;
Jingjing ZHANG
1
;
Qiao TANG
2
;
Shuangnan FU
1
;
Ning ZHANG
1
;
Zhaoyun HE
1
;
Jin ZHANG
1
;
Tianyi ZHANG
1
;
Pengcheng LIU
1
;
Man GONG
1
Author Information
1. Department of Traditional Chinese Medicine Liver Diseases, Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
2. College of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China.
- Publication Type:Multicenter Study
- Keywords:
hepatitis B virus;
kidney dysfunction;
liver failure;
prognosis;
tryptophan
- MeSH:
Humans;
Tryptophan/blood*;
Retrospective Studies;
Acute-On-Chronic Liver Failure/virology*;
Male;
Female;
Middle Aged;
Adult;
Prognosis;
Hepatitis B/complications*;
Hepatitis B virus
- From:
Journal of Southern Medical University
2025;45(1):59-64
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:To explore the correlation of serum tryptophan level with 90-day mortality risk in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).
METHODS:This retrospective study was conducted among 108 patients with HBV-ACLF, whose survival outcomes within 90 days after diagnosis were recorded. The correlation of baseline serum tryptophan levels measured by high-performance liquid chromatography with 90-day mortality of the patients was analyzed, and the predictive value of serum tryptophan for 90-day mortality was explored.
RESULTS:Within 90 days after diagnosis, 53 (29.4%) of the patients died and 127 (70.6%) survived. The deceased patients had significantly lower baseline serum tryptophan levels than the survivors (7.31±3.73 pg/mL vs 13.32±7.15 pg/mL, P<0.001). Multivariate analysis suggested that serum tryptophan level was an independent factor correlated with mortality of HBV-ACLF after adjustment for confounding variables. The patients with serum tryptophan levels below the median level (10.14 pg/mL) at admission had significantly higher 90-day mortality risks than those with higher tryptophan levels (43.3% vs 15.6%, HR: 3.157, 95% CI: 1.713-5.817), and the complication by kidney dysfunction further increased the risk to 73.3% as compared with patients with higher serum tryptophan levels with normal kidney function (15.0%; HR: 7.558, 95% CI: 3.369-16.960). Serum tryptophan levels had an area under the receiver operating characteristic curve of 0.771 (95% CI: 0.699-0.844) for predicting 90-day mortality.
CONCLUSIONS:Serum tryptophan level is closely correlated with the survival outcomes of patients with HBV-ACLF, and a decreased tryptophan level indicates a high 90-day mortality risk, which can be further increased by the complication by kidney dysfunction.
