Evaluation of neutrophil/leukocyte ratio and organ failure score as predictors of reversibility and survival following an acute-on-chronic liver failure event

Hepatology Research : the Official Journal of the Japan Society of Hepatology
Danai AgiasotelliSpyros P Dourakis

Abstract

Acute-on-chronic liver failure (ACLF) is defined as an acute deterioration of liver disease with high mortality in patients with cirrhosis. The early mortality in ACLF is associated with organ failure and high leukocyte count. The time needed to reverse this condition and the factors affecting mortality after the early 30-day-period were evaluated. One hundred and ninety-seven consecutive patients with cirrhosis were included. Patients were prospectively followed up for 180 days. ACLF was diagnosed in 54.8% of the patients. Infection was the most common precipitating event in patients with ACLF. On multivariate analysis, only the neutrophil/leukocyte ratio and Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) score were associated with mortality. Hazard ratios for mortality of patients with ACLF compared with those without at different time end-points post-enrollment revealed that the relative risk of death in the ACLF group was 8.54 during the first 30-day period and declined to 1.94 during the second period of observation. The time varying effect of neutrophil/leukocyte ratio and CLIF-C score was negative (1% and 18% decline in the hazard ratio per month) while that of Model for End-Stage Liver Disease (MELD) was pos...Continue Reading

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Citations

Sep 28, 2018·Liver International : Official Journal of the International Association for the Study of the Liver·Iliana ManiSpyros P Dourakis
Jul 20, 2020·Alimentary Pharmacology & Therapeutics·Christine BernsmeierMark J W McPhail

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