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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2022
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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 |
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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 |
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