Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Authors

  • Qing Lei Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Kangjian Ao Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Yinhua Zhang Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Deqiang Ma Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Deping Ding Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Changzheng Ke Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Yue Chen Hubei University; Taihe Hospital; Department of Infectious Diseases
  • Jie Luo Hubei University; Taihe Hospital; Center for Evidence-Based Medicine and Clinical Research
  • Zhongji Meng Hubei University; Taihe Hospital; Institute of Biomedical Research

DOI:

https://doi.org/10.6061/clinics/2017(11)07

Keywords:

Hepatitis B Virus, Acute-on-Chronic Liver Failure, Prognosis

Abstract

OBJECTIVE: To investigate the impact of the baseline status of patients with hepatitis B virus-associated acute-on-chronic liver failure on short-term outcomes. METHODS: A retrospective study was conducted that included a total of 138 patients with hepatitis B virus-associated acute-on-chronic liver failure admitted to the Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, from November 2013 to October 2016. The patients were divided into a poor prognosis group (74 patients) and a good prognosis group (64 patients) based on the disease outcome. General information, clinical indicators and prognostic scores of the patients’ baseline status were analyzed, and a prediction model was established accordingly. RESULTS: Elder age, treatment with artificial liver support systems and the frequency of such treatments, high levels of white blood cells, neutrophils, neutrophil count/lymphocyte count ratio, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, urea, and prognostic scores as well as low levels of albumin and sodium were all significantly associated with the short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure. The predictive model showed that logit (p) = 3.068 + 1.003 × neutrophil count/lymphocyte count ratio - 0.892 × gamma-glutamyl transferase - 1.138 × albumin - 1.364 × sodium + 1.651 × artificial liver support therapy. CONCLUSION: The neutrophil count/lymphocyte count ratio and serum levels of gamma-glutamyl transferase, albumin and sodium were independent risk factors predicting short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure, and the administration of multiple treatments with artificial liver support therapy during the early stage is conducive to improved short-term outcomes.

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Published

2017-11-01

How to Cite

Lei, Q., Ao, K., Zhang, Y., Ma, D., Ding, D., Ke, C., Chen, Y., Luo, J., & Meng, Z. (2017). Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure. Clinics, 72(11), 686-692. https://doi.org/10.6061/clinics/2017(11)07

Issue

Section

Clinical Sciences