Acute-on-chronic liver failure in a multi-ethnic Asian city: A comparison of patients identified by Asia-Pacific Association for the Study of the Liver and European Association for the Study of the Liver definitions

World Journal of Hepatology
Anandraj Selva RajooGuan-Huei Lee

Abstract

To explore the applicability of the Asia-Pacific Association for the Study of the Liver (APASL) and European Association for the Study of the Liver (EASL) guidelines for acute-on-chronic liver failure (ACLF) in profiling patients and determining the outcome. Patients admitted to a tertiary hospital in Singapore with acute decompensation of liver disease from January 2004 to July 2014 are screened for ACLF according to the APASL and EASL criteria. The patients' data (including basic demographics, information about existing chronic liver disease, information about the acute decompensation, relevant laboratory values during admission, treatment, and outcome) are retrospectively analyzed to determine the background, precipitating factors and outcome. A total of 458 liver patients is analyzed, and 78 patients with ACLF are identified. Sixty-three patients (80.8%) meet the APASL criteria, 64 patients (82.1%) meet the EASL criteria, and 49 patients (62.8%) fulfilled both criteria. The most common causes of acute liver injury are bacterial infections (59.0%), hepatitis B flare (29.5%), and variceal bleeding (24.4%). The common aetiologies of the underlying chronic disease included hepatitis B (43.6%), alcoholic (20.5%) and cryptogenic ...Continue Reading

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Citations

Aug 18, 2018·Hepatology International·Shiv Kumar Sarin, Ashok Choudhury
Sep 12, 2020·Journal of Clinical Laboratory Analysis·JinFei ZhangHui Chen
Jun 15, 2021·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Bershic ValantineAyaskanta Singh
Aug 17, 2021·Canadian Journal of Gastroenterology & Hepatology·Fernando Comunello SchacherMario Reis Álvares-da-Silva

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