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Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study.
Zhang, Yuan-Yao; Luo, Sen; Li, Hai; Sun, Shu-Ning; Wang, Xian-Bo; Zheng, Xin; Huang, Yan; Li, Bei-Ling; Gao, Yan-Hang; Qian, Zhi-Ping; Liu, Feng; Lu, Xiao-Bo; Liu, Jun-Ping; Ren, Hao-Tang; Zheng, Yu-Bao; Yan, Hua-Dong; Deng, Guo-Hong; Qiao, Liang; Zhang, Yan; Gu, Wen-Yi; Xiang, Xiao-Mei; Zhou, Yi; Hou, Yi-Xin; Zhang, Qun; Xiong, Yan; Zou, Cong-Cong; Chen, Jun; Huang, Ze-Bing; Jiang, Xiu-Hua; Qi, Ting-Ting; Chen, Yuan-Yuan; Gao, Na; Liu, Chun-Yan; Yuan, Wei; Mei, Xue; Li, Jing; Li, Tao; Zheng, Rong-Jiong; Zhou, Xin-Yi; Zhao, Jun; Meng, Zhong-Ji.
Afiliação
  • Zhang YY; Department of Infectious Disease, Institute of Biomedical Research, Regulatory Mechanism and Targeted Therapy for Liver Cancer Shiyan Key Laboratory, Hubei provincial Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 44
  • Luo S; Department of Infectious Disease, Institute of Biomedical Research, Regulatory Mechanism and Targeted Therapy for Liver Cancer Shiyan Key Laboratory, Hubei provincial Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 44
  • Li H; Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China.
  • Sun SN; Department of Infectious Diseases, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400000, China.
  • Wang XB; Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100020, China.
  • Zheng X; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430020, Hubei Province, China.
  • Huang Y; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha 110051, Hunan Province, China.
  • Li BL; Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
  • Gao YH; Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
  • Qian ZP; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai 200093, China.
  • Liu F; Tianjin Institute of Hepatology, Nankai University Second People's Hospital, Tianjin 300192, China.
  • Lu XB; Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
  • Liu JP; Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan 250000, Shandong Province, China.
  • Ren HT; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China.
  • Zheng YB; Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.
  • Yan HD; Department of Infectious Diseases, Ningbo No. 2 Hospital, University of Chinese Academy of Sciences, Ningbo 315153, Zhejiang Province, China.
  • Deng GH; Department of Infectious Diseases, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400000, China.
  • Qiao L; Department of Gastroenterology, The 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China.
  • Zhang Y; Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China.
  • Gu WY; Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China.
  • Xiang XM; Department of Infectious Diseases, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400000, China.
  • Zhou Y; Department of Infectious Diseases, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400000, China.
  • Hou YX; Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
  • Zhang Q; Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100020, China.
  • Xiong Y; Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100020, China.
  • Zou CC; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430020, Hubei Province, China.
  • Chen J; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430020, Hubei Province, China.
  • Huang ZB; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Nation Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
  • Jiang XH; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Nation Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
  • Qi TT; Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
  • Chen YY; Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
  • Gao N; Department of Infectious Disease, Institute of Biomedical Research, Regulatory Mechanism and Targeted Therapy for Liver Cancer Shiyan Key Laboratory, Hubei provincial Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 44
  • Liu CY; Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
  • Yuan W; Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
  • Mei X; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai 200093, China.
  • Li J; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai 200093, China.
  • Li T; Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan 250000, Shandong Province, China.
  • Zheng RJ; Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan 250000, Shandong Province, China.
  • Zhou XY; Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
  • Zhao J; Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
  • Meng ZJ; School of Public Health, Hubei University of Medicine, Shiyan 442000, Hubei Province, China.
World J Hepatol ; 16(5): 809-821, 2024 May 27.
Article em En | MEDLINE | ID: mdl-38818287
ABSTRACT

BACKGROUND:

Acute-on-chronic liver disease (AoCLD) accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.

AIM:

To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of AoCLD.

METHODS:

Patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure (ACLF) study cohort were included in this study. The clinical characteristics and outcomes, and the 90-d survival rate associated with each clinical type of AoCLD were analyzed, using the Kaplan-Meier method and the log-rank test.

RESULTS:

A total of 3375 patients with AoCLD were enrolled, including 1679 (49.7%) patients with liver cirrhosis acute decompensation (LC-AD), 850 (25.2%) patients with ACLF, 577 (17.1%) patients with chronic hepatitis acute exacerbation (CHAE), and 269 (8.0%) patients with liver cirrhosis active phase (LC-A). The most common cause of chronic liver disease (CLD) was HBV infection (71.4%). The most common precipitants of AoCLD was bacterial infection (22.8%). The 90-d mortality rates of each clinical subtype of AoCLD were 43.4% (232/535) for type-C ACLF, 36.0% (36/100) for type-B ACLF, 27.0% (58/215) for type-A ACLF, 9.0% (151/1679) for LC-AD, 3.0% (8/269) for LC-A, and 1.2% (7/577) for CHAE.

CONCLUSION:

HBV infection is the main cause of CLD, and bacterial infection is the main precipitant of AoCLD. The most common clinical type of AoCLD is LC-AD. Early diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article