Cargando…

Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index

Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of liver function in cirrhotic patients. Since treatment of this condition is difficult, its prevention is of paramount importance. The predictors of ACLF are yet to be identified. To determine the prognosis...

Descripción completa

Detalles Bibliográficos
Autores principales: Watanabe, Yusuke, Osaki, Akihiko, Waguri, Nobuo, Tsuchiya, Atsunori, Terai, Shuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646499/
https://www.ncbi.nlm.nih.gov/pubmed/36343064
http://dx.doi.org/10.1097/MD.0000000000031328
_version_ 1784827178859364352
author Watanabe, Yusuke
Osaki, Akihiko
Waguri, Nobuo
Tsuchiya, Atsunori
Terai, Shuji
author_facet Watanabe, Yusuke
Osaki, Akihiko
Waguri, Nobuo
Tsuchiya, Atsunori
Terai, Shuji
author_sort Watanabe, Yusuke
collection PubMed
description Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of liver function in cirrhotic patients. Since treatment of this condition is difficult, its prevention is of paramount importance. The predictors of ACLF are yet to be identified. To determine the prognosis of cirrhotic and ACLF patients, we conducted a retrospective study to analyze each parameter in ACLF patients. Cirrhotic patients with serum total-bilirubin level ≥5.0 mg/dL and prothrombin time (PT) value ≤40% after acute insults were diagnosed with ACLF, whereas patients who met one of the above criteria were diagnosed with extended type of ACLF (EX-ACLF). Overall, in this study, 18 ACLF and 16 EX-ACLF patients retrospectively investigated between 2008 and 2020, and each data was analyzed during and before acute insults. In the analysis during acute insults, renal and coagulation functions showed significant differences between the ACLF and EX-ACLF groups. Furthermore, the mortality rate in the ACLF group was higher than that in the EX-ACLF group. In the analysis before acute insults, aspartate aminotransferase (AST), Fibrosis-4 (FIB-4) index score, and AST to platelet ratio index (APRI) showed significant differences between the two groups. Among these, the FIB-4 index score correlated best with ACLF severity for identifying cirrhotic patients with poor prognosis. The FIB-4 index is the most useful predictor of ACLF severity. Careful management of cirrhotic patients with a high FIB-4 index score is considered beneficial to prevent ACLF occurrence.
format Online
Article
Text
id pubmed-9646499
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-96464992022-11-14 Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index Watanabe, Yusuke Osaki, Akihiko Waguri, Nobuo Tsuchiya, Atsunori Terai, Shuji Medicine (Baltimore) 4500 Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of liver function in cirrhotic patients. Since treatment of this condition is difficult, its prevention is of paramount importance. The predictors of ACLF are yet to be identified. To determine the prognosis of cirrhotic and ACLF patients, we conducted a retrospective study to analyze each parameter in ACLF patients. Cirrhotic patients with serum total-bilirubin level ≥5.0 mg/dL and prothrombin time (PT) value ≤40% after acute insults were diagnosed with ACLF, whereas patients who met one of the above criteria were diagnosed with extended type of ACLF (EX-ACLF). Overall, in this study, 18 ACLF and 16 EX-ACLF patients retrospectively investigated between 2008 and 2020, and each data was analyzed during and before acute insults. In the analysis during acute insults, renal and coagulation functions showed significant differences between the ACLF and EX-ACLF groups. Furthermore, the mortality rate in the ACLF group was higher than that in the EX-ACLF group. In the analysis before acute insults, aspartate aminotransferase (AST), Fibrosis-4 (FIB-4) index score, and AST to platelet ratio index (APRI) showed significant differences between the two groups. Among these, the FIB-4 index score correlated best with ACLF severity for identifying cirrhotic patients with poor prognosis. The FIB-4 index is the most useful predictor of ACLF severity. Careful management of cirrhotic patients with a high FIB-4 index score is considered beneficial to prevent ACLF occurrence. Lippincott Williams & Wilkins 2022-11-04 /pmc/articles/PMC9646499/ /pubmed/36343064 http://dx.doi.org/10.1097/MD.0000000000031328 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 4500
Watanabe, Yusuke
Osaki, Akihiko
Waguri, Nobuo
Tsuchiya, Atsunori
Terai, Shuji
Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index
title Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index
title_full Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index
title_fullStr Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index
title_full_unstemmed Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index
title_short Prognostic study of acute-on-chronic liver failure patients: Usefulness of the fibrosis-4 index
title_sort prognostic study of acute-on-chronic liver failure patients: usefulness of the fibrosis-4 index
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646499/
https://www.ncbi.nlm.nih.gov/pubmed/36343064
http://dx.doi.org/10.1097/MD.0000000000031328
work_keys_str_mv AT watanabeyusuke prognosticstudyofacuteonchronicliverfailurepatientsusefulnessofthefibrosis4index
AT osakiakihiko prognosticstudyofacuteonchronicliverfailurepatientsusefulnessofthefibrosis4index
AT wagurinobuo prognosticstudyofacuteonchronicliverfailurepatientsusefulnessofthefibrosis4index
AT tsuchiyaatsunori prognosticstudyofacuteonchronicliverfailurepatientsusefulnessofthefibrosis4index
AT teraishuji prognosticstudyofacuteonchronicliverfailurepatientsusefulnessofthefibrosis4index