Table 1. Characteristics and mortality of patients with and without ACLF during the study period (admission plus hospitalization).
| Characteristics | No ACLF (N = 590) | ACLF (N = 300) | p-value | ACLF grade I (N = 55) | ACLF grade II (N = 147) | ACLF grade III (N = 98) | p-value |
|---|---|---|---|---|---|---|---|
| Age (y) | 51.8 ± 10.7 | 46.5 ± 11.3 | <0.001 | 49.6 ± 11.3 | 44.8 ± 11.2 | 47.1 ± 11.0 | <0.001 |
| Male sex | 450(76.3) | 233(77.7) | 0.641 | 41(74.6) | 119(81.0) | 73(74.5) | 0.581 |
| Ascites | 482(81.7) | 229(76.6) | 0.072 | 42(76.4) | 115(78.8) | 72(73.5) | 0.235 |
| Mean arterial pressure (mm Hg) | 87 ± 11 | 84 ± 18 | 0.011 | 87 ± 18 | 87 ± 15 | 78 ± 21 | <0.001 |
| Cause of cirrhosis | 0.002 | <0.001 | |||||
| HBV alone | 544(92.3) | 263(87.7) | 47(85.6) | 130(88.5) | 86(87.7) | ||
| HBV + Alcohol | 36(6.1) | 19(6.3) | 4(7.2) | 7(4.7) | 8(8.2) | ||
| HBV + other hepatitis virus | 5(0.8) | 12(4.0) | 2(3.6) | 9(6.1) | 1(1.0) | ||
| HBV + schistosomiasis | 5(0.8) | 6(2.0) | 2(3.6) | 1(0.7) | 3(3.1) | ||
| HBV-DNA level (IU/ml): | |||||||
| ≤100 | 97 (16.4) | 60 (20.0) | 0.069 | 7(12.7) | 25(17.0) | 28(28.6) | 0.058 |
| >100–2 × 104 | 278 (47.1) | 157 (52.3) | 30(54.5) | 75(51.0) | 52(53.1) | ||
| >2 × 104–2 × 106 | 176 (29.8) | 68 (22.7) | 13(23.6) | 39(26.5) | 16(16.3) | ||
| >2 × 106 | 39 (6.6) | 15 (5.0) | 5(9.1) | 8(5.4) | 2(2.0) | ||
| HbeAg positve# | 194(33.8) | 99(35.2) | 0.678 | 14(28.6) | 53(36.3% | 32(73.2%) | 0.556 |
| Treatment with NUCs* | 114 (19.3) | 95 (31.7) | <0.0001 | 10(20) | 57(37.0) | 28(29.2) | 0.065 |
| Types of NUCs treatment before enrollment: | |||||||
| Lamivudinealone | 67/114 (58.8) | 48/95 (50.5) | 0.233 | 4/10(40.0) | 30/57(52.6) | 14/28(50.0) | 0.760 |
| Entecaviralone | 16/114 (14.0) | 23/95 (24.2) | 0.06 | 4/10 (40.0) | 14/57 (24.6) | 5/28 (17.9) | 0.391 |
| Adefoviralone | 15/114 (13.2) | 7/95 (7.4) | 0.174 | 2/10 (20.0) | 2/57 (3.5) | 3/28 (10.7) | 0.167 |
| Telbivudinealone | 3 /114(2.6) | 2 /95(2.1) | 0.803 | 0/10 (0.0) | 1/57 (1.8) | 1/28 (3.6) | 0.703 |
| Tenofoviralone | 0 /114(0.0) | 0/95 (0.0) | 1.000 | 0/10 (0.0) | 0/57 (0.0) | 0/28 (0.0) | 1.000 |
| ≥2 NUCs | 13/114 (11.4) | 15/95 (15.8) | 0.354 | 0/10 (0.0) | 10/57 (17.5) | 5/28 (17.9) | 0.161 |
| Potential precipitating events of ACLF | |||||||
| Bacterial infection*** | 35(5.9) | 59(19.7) | <0.001 | 13(23.6) | 22(15.1) | 24(24.5) | <0.001 |
| Gastrointestinal haemorrhage*** | 53(9.0) | 23(7.7) | 0.507 | 5(9.1) | 6(4.1) | 12(12.2) | 0.131 |
| Active alcoholism** | 36(6.1) | 30(10.0) | 0.036 | 4(7.3) | 18(12.2) | 8(8.2) | 0.087 |
| HBV reactivation*** | 14(2.4) | 27(9.0) | <0.001 | 5(9.1) | 16(10.9) | 6(6.1) | <0.001 |
| Superimposed by hepatitis viruses | 5(0.8) | 9(3.0) | 0.031 | 1(1.8) | 7(4.8) | 1(1.0) | 0.182 |
| Surgery** | 7(1.2) | 2(0.7) | 0.705 | 0(0.0) | 0(0.0) | 2(2.0) | 0.105 |
| Hepatotoxic drugs or herbs** | 8(1.4) | 7(2.3) | 0.284 | 1(1.8) | 1(0.7) | 5(5.1) | 0.083 |
| Portal vein thrombosis by CT/MRI*** | 50(8.5) | 9(3.0) | 0.002 | 3(5.5) | 3(2.0) | 3(3.1) | 0.486 |
| Precipitating Events(PEs) | |||||||
| No PE | 267(45.3) | 135(45.0) | 0.991 | 23(41.8) | 75(51.0) | 37(37.8) | 0.253 |
| 1 PE | 257(43.6) | 132(44.0) | 25(45.5) | 60(40.8) | 47(48.0) | ||
| >1 PE | 66(11.2) | 33(11.0) | 7(12.7) | 12(8.2) | 14(14.3) | ||
| Organ failure | |||||||
| Liver failure | 46(7.8) | 233(77.7) | <0.001 | 26(47.3) | 129(87.8) | 78(79.6) | <0.001 |
| Kidney failure | 0(0.0) | 85(28.3) | <0.001 | 23(41.8) | 16(10.9) | 46(47.0) | <0.001 |
| Cerebral failure | 3(0.5) | 71(23.7) | <0.001 | 1(1.8) | 12(8.2) | 58(59.2) | <0.001 |
| Coagulation failure | 58(9.8) | 203(67.7) | <0.001 | 4(7.3) | 120(81.6) | 79(80.6) | <0.001 |
| Circulation failure | 2(0.3) | 57(19.0) | <0.001 | 1(1.8) | 11(7.5) | 45(45.9) | <0.001 |
| Lungs failure | 0(0.0) | 43(14.3) | <0.001 | 0(0.0) | 6(4.1) | 37(37.8) | <0.001 |
| Renal dysfunction | 2(0.4) | 44(14.6) | <0.001 | 22(40.7) | 14(9.9) | 8(8.3) | <0.001 |
| Cerebral dysfunction | 17(2.9) | 54(18.0) | <0.001 | 19(34.6) | 28(19.1) | 10(10.2) | <0.001 |
| Laboratory data | |||||||
| Hematocrit (%) | 30 ± 7 | 30 ± 8 | 0.876 | 29 ± 8 | 31 ± 8 | 29 ± 8 | 0.218 |
| Platelet count (×109/L) | 73 ± 56 | 85 ± 63 | 0.007 | 92 ± 79 | 80 ± 56 | 88 ± 64 | 0.020 |
| Serum bilirubin (mg/dL) | 5.1 ± 8.5 | 26.5 ± 16.3 | <0.001 | 18.2 ± 17.8 | 29.4 ± 14.6 | 26.9 ± 16.2 | <0.001 |
| International normalized ratio | 1.6 ± 0.6 | 3.2 ± 2.1 | <0.001 | 1.8 ± 0.4 | 3.5 ± 2.6 | 3.5 ± 1.4 | <0.001 |
| Alanine aminotransferase (U/L) | 75 ± 203 | 315 ± 589 | <0.001 | 162 ± 281 | 327 ± 563 | 385 ± 730 | <0.001 |
| Aspartate aminotransferase (U/L) | 88 ± 174 | 254 ± 451 | <0.001 | 117 ± 103 | 292 ± 530 | 274 ± 430 | <0.001 |
| γ-Glutamyltransferase (U/L) | 61 ± 71 | 70 ± 98 | 0.159 | 70 ± 99 | 70 ± 103 | 69 ± 89 | 0.491 |
| Serum creatinine (mg/dL) | 0.8 ± 0.2 | 1.5 ± 1.5 | <0.001 | 1.9 ± 2.2 | 1.2 ± 1.1 | 1.9 ± 1.4 | <0.001 |
| Serum sodium (mmol/L) | 136 ± 9 | 130 ± 7.5 | <0.001 | 132 ± 6.2 | 130 ± 7 | 129 ± 9 | <0.001 |
| Leukocytecount (× 109/L) | 4.7 ± 3.3 | 10.3 ± 6.8 | <0.001 | 8.1 ± 5.2 | 9.5 ± 5.3 | 12.8 ± 8.7 | <0.001 |
| Previous decompensation | 0.002 | 0.015 | |||||
| No | 243(41.2) | 157(52.3) | 28(50.9) | 80(54.4) | 49(50.0) | ||
| Yes | 347(58.8) | 143(47.7) | 27(49.1) | 67(45.6) | 49(50.0) | ||
| Mortality(LT-free) | |||||||
| 28 days | 15(2.6) | 132(44.0) | <0.001 | 13(23.6) | 60(40.8) | 59(60.2) | <0.001 |
| 90 days | 27(4.6) | 150(50.0) | <0.001 | 19(34.6) | 69(46.9) | 62(63.3) | <0.001 |
| 180 days | 34(5.8) | 153(51.0) | <0.001 | 19(34.6) | 70(47.6) | 64(63.3) | <0.001 |
| 365 days | 49(8.3) | 155(51.7) | <0.001 | 21(38.2) | 70(47.6) | 64(63.3) | <0.001 |
*within 6 months prior admission; **within 3months prior admission; ***at admission; #35 patients (19 patients had ACLF) didn’t have HbeAg test.