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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 232 - 241 (10page)
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Background/Aims: Hepatitis-B-related acute-on-chronic liver failure has a poor prognosis. However, the advent of potent oral antiviral agents means that some patients can now recover with medical treatment. We aimed to identify the prognostic factors for hepatitis-B-related acute-on-chronic liver failure including the initial as well as the dynamically changing clinical parameters during admission.
Methods: Sixty-seven patients were retrospectively enrolled from 2003 to 2012 at Samsung Medical Center. The patients were classified into three categories: Recovery group (n=23), Liver transplantation group (n=28), and Death group (n=16). The Liver transplantation and Death groups were combined into an Unfavorable prognosis group. We analyzed the prognostic factors including the Model for End-Stage Liver Disease (MELD) scores determined at 3-day intervals.
Results: A multivariable analysis showed that the unfavorable prognostic factors were a high initial MELD score (≥28) (odds ratio [OR] =6.64, p=0.015), moderate-to-severe ascites at admission (OR=6.71, P=0.012), and the aggravation of hepatic encephalopathy during hospitalization (≥grade III) (OR=15.41, P=0.013). Compared with the baseline level, significant reductions in the MELD scores were observed on the 7th day after admission in the Recovery group (P=0.016).
Conclusions: Dynamic changes in clinical parameters during admission are useful prognostic factors for hepatitis-B-related acute-on-chronic liver failure. (Clin Mol Hepatol 2015;21:232-241)
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참고문헌 (21)
참고문헌 신청
American College of Chest Physicians / 1992 / Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of
Arroyo V / 1996 / Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club / Hepatology 23 : 164 ~ 176
Bajaj JS / 2009 / Spectrum of neurocognitive impairment in cirrhosis : Implications for the assessment of hepatic encephalopathy / Hepatology 50 : 2014 ~ 2021
Bajaj JS / 2012 / Second infections independently increase mortality in hospitalized patients with cirrhosis : the North American consortium for the study of end-stage liver
Chang TT / 2010 / Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B / Hepa
Arroyo V / 1996 / Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club / Hepatology 23 : 164 ~ 176
Bajaj JS / 2009 / Spectrum of neurocognitive impairment in cirrhosis : Implications for the assessment of hepatic encephalopathy / Hepatology 50 : 2014 ~ 2021
Bajaj JS / 2012 / Second infections independently increase mortality in hospitalized patients with cirrhosis : the North American consortium for the study of end-stage liver
Chang TT / 2010 / Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B / Hepa
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