Table 1.
Clinical characteristics, routine laboratory tests, and inflammatory mediators, all at enrollment, across the three distinct phenotypes of patients with acutely decompensated (AD) cirrhosis who were free of ACLF (AD-1, AD-2, AD-3), and the group of patients with ACLF.
| Variable | AD-1 | AD-2 | AD-3 | ACLF | P-value |
|---|---|---|---|---|---|
| (N = 155) | (N = 121) | (N = 66) | (N = 161) | ||
| CLINICAL CHARACTERISTICS | |||||
| Age—year | 57.6 ± 11.90 | 59.2 ± 10.35 | 51.7 ± 11.25 | 57.3 ± 11.45 | < 0.001 |
| Male gender—no./total no. (%) | 99/155 (63.9) | 83/121 (68.6) | 45/66 (68.2) | 108/161 (67.1) | 0.843 |
| Mean arterial pressure—mm Hg | 84.1 ± 10.87 | 83.1 ± 13.02 | 84.9 ± 10.63 | 80.8 ± 13.40 | 0.050 |
| PRECIPITATING EVENTS—NO./TOTAL NO. (%) | |||||
| Alcohol consumption | 19/144 (13.2) | 7/112 (6.3) | 14/59 (23.7) | 27/150 (18.0) | 0.008 |
| Mortality at 90 days | 22/155 (14.2) | 21/121 (17.4) | 12/66 (18.2) | 59/161 (36.6) | < 0.001 |
| ETIOLOGY OF CIRRHOSIS—NO./TOTAL NO. (%) | |||||
| Alcoholic | 66/145 (45.5) | 55/113 (48.7) | 36/63 (57.1) | 90/152 (59.) | 0.080 |
| HCV | 40/145 (27.6) | 28/113 (24.8) | 10/63 (15.9) | 27/152 (17.8) | 0.109 |
| Alcohol ± HCV | 11/145 (7.6) | 13/113 (11.5) | 5/63 (7.9) | 17/152 (11.2) | 0.623 |
| Others | 28/145 (19.3) | 17/113 (15.0) | 12/63 (19.0) | 18/152 (11.8) | 0.300 |
| MEDIAN VALUES FOR ROUTINE LABORATORY TESTS (IQR) | |||||
| Serum albumin—g/dl | 2.9 (2.50–3.25) | 2.9 (2.60–3.30) | 2.8 (2.40–3.10) | 3.0 (2.40–3.40) | 0.157 |
| Serum bilirubin—mg/d | 2.5 (1.49–5.18) | 2.8 (1.56–5.20) | 13.7 (4.90–22.30) | 6.1 (2.00–14.37) | < 0.001 |
| Serum creatinine—mg/dl | 0.8 (0.66–1.00) | 1.5 (0.98–1.70) | 0.8 (0.70–1.05) | 2.2 (0.98–3.04) | < 0.001 |
| C-reactive protein—mg/L | 16.7 (6.80–41.40) | 17.9 (6.50–43.00) | 19.9 (6.50–34.00) | 25.0 (9.70–50.40) | 0.163 |
| International Normalized Ratio | 1.5 (1.27–1.73) | 1.5 (1.27–1.66) | 1.7 (1.39–2.20) | 1.7 (1.37–2.30) | < 0.001 |
| Platelets— × 109/L | 95.0 (63.00–131.00) | 84.5 (53.50–139.50) | 81.0 (43.00–135.00) | 76.0 (53.00–121.00) | 0.094 |
| White-cell count— × 1 09/L | 6.5 (4.38–9.88) | 6.1 (4.60–7.90) | 6.6 (4.08–10.72) | 8.0 (5.30–12.20) | < 0.001 |
| MEDIAN VALUES FOR INFLAMMATORY MEDIATORS (IQR) | |||||
| TNF-α—pg/ml | 17.9 (13.43–26.64) | 24.2 (17.88–34.23) | 19.9 (13.05–29.26) | 29.0 (17.38–42.83) | < 0.001 |
| IL-6—pg/ml | 21.2 (11.71–44.47) | 25.0 (12.75–54.20) | 24.6 (14.49–47.12) | 36.7 (13.79–106.83) | < 0.001 |
| IL-8—pg/ml) | 35.9 (19.45–75.22) | 37.3 (21.84–63.59) | 78.4 (41.69–220.92) | 84.5 (38.64–165.10) | < 0.001 |
| MCP-1—pg/ml | 316.8 (235.9–395.7) | 323.1 (209.49–455.92) | 372.2 (254.60–494.73) | 410.3 (293.88–690.00) | < 0.001 |
| IP-10—pg/ml | 904.6 (530.4–1499.0) | 1200.0 (627.0–2255.0) | 950.3 (639.9–1718.0) | 1147.0 (651.2–2123.0) | 0.022 |
| MIP-1ß—pg/ml | 20.1 (13.55–37.43) | 22.6 (12.93–34.30) | 30.2 (16.88–45.41) | 26.2 (17.89–42.55) | 0.002 |
| G-CSF—pg/ml | 22.6 (12.32–54.85) | 24.0 (11.19–52.24) | 23.0 (12.80–46.65) | 30.5 (13.85–81.63) | 0.186 |
| GM-CSF—pg/ml | 5.0 (2.28–9.08) | 4.5 (1.75–10.98) | 7.5 (3.68–15.87) | 6.8 (3.47–15.97) | 0.003 |
| IL-10—pg/ml | 3.0 (0.90–9.36) | 4.0 (1.37–13.07) | 5.3 (1.88–13.39) | 7.2 (1.90–25.78) | < 0.001 |
| IL1-ra—pg/ml | 11.9 (5.40–25.90) | 10.4 (4.52–23.03) | 13.4 (6.14–40.97) | 18.7 (8.56–50.48) | < 0.001 |
| IFNγ—pg/ml | 4.4 (1.65–19.38) | 6.7 (2.38–24.29) | 7.8 (2.82–18.85) | 6.0 (2.32–23.12) | 0.107 |
| Eotaxin—pg/ml | 103.7 (68.43–152.08) | 120.4 (90.48–162.49) | 137.0 (94.67–173.76) | 123.5 (86.55–177.21) | 0.008 |
| IL-17A—pg/ml | 3.1 (1.37–13.10) | 4.2 (2.03–10.00) | 3.8 (1.75–11.31) | 4.8 (1.62–14.90) | 0.376 |
| IL-7—pg/ml | 2.5 (0.85–7.46) | 2.7 (1.13–11.74) | 4.3 (1.38–8.80) | 3.5 (1.62–11.07) | 0.135 |
| HNA2—% | 4.2 (2.35–8.07) | 6.9 (3.79–10.99) | 5.6 (3.07–8.85) | 11.0 (6.25–15.15) | < 0.001 |
Patients with acutely decompensated cirrhosis were classified as having the AD-1, AD-2, or AD-3 phenotype or having ACLF according to the EASL-CLIF Consortium criteria (1, 2). Data are shown as means ± SD or median (range).
P-values were calculated by unpaired Students' t-test or Kruskall-Wallis test where appropriate.
HCV denotes hepatitis C virus; IQR interquartile range; TNF, umor necrosis factor; IL, interleukin; MCP-1, monocyte chemotactic protein 1; IP-10, 10 kDa interferon gamma-induced protein; MIP-1ß, macrophage inflammatory protein 1-beta; G-CSF, granulocyte colony-stimulating factor; GM-CSF, granulocyte-macrophage colony-stimulating factor; IL-1ra, interleukin-1 receptor antagonist protein; IFN, interferon; HNA2, human non-mercaptalbumin 2.