Predicting 90-day mortality at admission and 7 days post-admission among patients with hepatitis B virus-related acute-on-chronic liver failure

Author(s):  
Fang Chen ◽  
Yuzhi Shi ◽  
Shurong Ran ◽  
Xueqin Liu ◽  
Jian Xu

Abstract Objective: To investigate the relationship between baseline characteristics and 90-day mortality in hepatitis B virus-related acute-on-chronic liver failure patients. Methods: The retrospective study was conducted at Fuling Centre Hospital, Chongqing, China, and comprised data from July 2015 to June 2018 of  hepatitis B virus-related acute-on-chronic liver failure patients. Demographic characteristics and clinical features at admission and 7 days post-admission were noted. The data was then divided into two groups based on a patient’s 90-day survival status, and their clinical and lab characteristics were compared using SPSS 16. Results: Of the 120 patients screened, 100(83.3%) were included; 75(75%) males and 25(25%) females.  The overall mean age was 50.04±14.61 years.  There were 68(68%) in the surviving group and 32(432%) in the non-surviving group. Patients who had hyper-leukocytosis, hypoalbuminemia, lower prothrombin time activity, ascites, hepatic encephalopathy, higher alanine aminotransferase levels and renal dysfunction at admission had poor prognoses (p<0.05). At 7 days post-admission, the non-surviving group had lower platelet count, higher aspartate aminotransferase level, lower bilirubin normalisation rate and higher total bile acid levels (p<0.05). Conclusions: Baseline organ failure severity was found to determine the outcome more strongly than the underlying cause. Key Words: Hepatitis B, Acute-on-chronic liver failure, Prognosis.

Author(s):  
Xuebing Yao ◽  
Haiping Yu ◽  
Guoyin Fan ◽  
Haihong Xiang ◽  
Lin Long ◽  
...  

The relationship between the progression of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) and the gut microbiota is poorly understood, and an HBV-ACLF-related microbiome has yet to be identified. In this study alterations in the fecal microbiome of 91 patients with HBV-ACLF (109 stool samples), including a cohort of nine patients at different stages of HBV-ACLF, were determined by high-throughput 16S rDNA sequencing. The operational taxonomic units and Shannon indexes indicated that the diversity and abundance of the gut microbiome significantly decreased with the progression of HBV-ACLF (p &lt;0.05). The relative abundance of the Bacteroidetes phylum in the microbiome was significantly reduced, whereas the abundance of potentially pathogenic bacteria, such as Veilonella, Streptococcus, Enterococcus, and Klebsiella, was highly enriched in the HBV-ACLF group compared with the healthy control group. The abundance of Bacteroidetes was negatively correlated with the level of serum alpha fetoprotein, and the abundance of Veilonella was positively correlated with serum total bilirubin (TBIL). Furthermore, the abundance of Coprococcus was significantly negatively correlated with the level of serum TBIL and the international normalized ratio and positively correlated with prothrombin time activity. Our findings suggest that the gut microbiota plays an important role in the development of HBV-ACLF.


2018 ◽  
Vol 48 (7) ◽  
pp. 750-760 ◽  
Author(s):  
Daxian Wu ◽  
Zeyu Sun ◽  
Xiaoli Liu ◽  
Qunfang Rao ◽  
Wenqian Chen ◽  
...  

2018 ◽  
Vol 30 (10) ◽  
pp. 1224-1229 ◽  
Author(s):  
Bin Chen ◽  
Yong-Hong Wang ◽  
Jin-Qin Qian ◽  
Dong-Bo Wu ◽  
En-Qiang Chen ◽  
...  

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