Table 1.
Basic clinical characteristics of patients with HBV- ACLF
| Patient’s Characteristics | All patients (n = 684) | Training cohort (n = 423) | Validation cohorts (n = 261) | P value |
|---|---|---|---|---|
| Age (yr) | 43.9 ± 11.6 | 43.8 ± 11.4 | 43.9 ± 11.6 | 0.440 |
| Male % | 582 (85.1) | 349 (82.5) | 233 (89.3) | 0.016 |
| Complications | ||||
| Hyponatremia (n/%) | 242 (35.4) | 175 (41.4) | 67 (25.7) | < 0.001 |
| Astices (n/%) | 405 (59.2) | 279 (66.0) | 126 (48.3) | 0.010 |
| Spontaneous bacterial peritonitis (n/%) | 82 (12.0) | 32 (7.5) | 50 (19.2) | < 0.001 |
| HE (n/%) | 122 (17.8) | 98 (23.2) | 24 (9.2) | |
| HE grade I-II (n/%) | 92 (13.5) | 76 (18.0) | 16 6.1) | < 0.001 |
| HE grade III-IV (n/%) | 25 (3.7) | 22 (5.2) | 3 (1.1) | 0.006 |
| Hepatorenal syndrome (n/%) | 41 (6.0) | 38 (8.9) | 3 (1.1) | < 0.001 |
| Organ failures | ||||
| Liver (n/%) | 559 (87.6) | 326 (77.1) | 233 (89.3) | < 0.001 |
| Kidney (n/%) | 23 (3.4) | 19 (4.5) | 4 (1.5) | 0.037 |
| Brain (n/%) | 26 (3.8) | 22 (5.2) | 4 (1.5) | 0.015 |
| Coagulation (n/%) | 158 (23.1) | 100 (23.6) | 58 (22.2) | 0.669 |
| Circulatory (n/%) | 2 (0.2) | 2 (0.5) | 0 (0) | 0.266 |
| Respiratory (n/%) | 1 (0.1) | 1 (0.2) | 0 (0) | 0.432 |
| Treatment with NUCs | 597 (87.3%) | 377 (89.1%) | 220 (84.3%) | 0.065 |
| Lamivudine alone (n/%) | 245 (35.8%) | 112 (26.5%) | 133 (60.0%) | < 0.001 |
| Entecavir alone (n/%) | 217 (31.7%) | 209 (49.4%) | 8 (3.1%) | < 0.001 |
| Adefovir alone (n/%) | 79 (11.5%) | 17 (4.0%) | 62 (23.8%) | < 0.001 |
| Telbivudine alone (n/%) | 36 (5.2%) | 3 (0.7%) | 3 (1.1%) | 0.549 |
| Tenofovir alone (n/%) | 0 (0.%) | 0 (0%) | 0 (0%) | – |
| ≥ 2 types of NUCs (n/%) | 50 (7.3%) | 36 (8.5%) | 14 (5.4%) | 0.125 |
| Laboratory data | ||||
| ALT (U·L−1) | 347.9 (137.1, 829) | 443.2 (193.7, 939.0) | 245.0 (91.0, 582.8) | < 0.001 |
| AST (U·L−1) | 298.1 (139.5, 611.9) | 360.1 (176.3, 746.1) | 197.0 (102.0, 401.0) | < 0.001 |
| TBIL (μmo·L−1) | 323.5 ± 148.4 | 318.3 ± 149.3 | 331.9 ± 146.7 | 0.196 |
| Albumin (g·L− 1) | 31.0 ± 4.9 | 31.2 ± 4.8 | 30.6 ± 4.9 | 0.982 |
| GGT (U·L− 1) | 84 (52.0, 136.0) | 83.9 (52.3, 135.3) | 85.0 (51.0, 136.0) | 0.905 |
| ALP (U·L−1) | 138.5 (109.9172.8) | 129.6 (105.1, 165.8) | 156.4 ± 48.2 | < 0.001 |
| Cholinesterase (U·L−1) | 3080.7 ± 1659.9 | 3313.5 ± 1468.1 | 2510.0 (1426.0,3687) | < 0.001 |
| PTA (%) | 30.1 ± 9.6 | 28.6 ± 10.2 | 32.6 ± 8.0 | < 0.001 |
| INR | 2.3 ± 0.8 | 2.0 (1.8,2.5) | 2.1 (1.8,2.5) | 0.107 |
| White blood cell (× 109·L−1) | 6.6 (4.9, 8.9) | 7.0 (5.2, 9.5) | 6.4 (4.6, 8.1) | 0.044 |
| Neutrophil count (× 109·L−1) | 4.5 (3.2, 6.9) | 4.7 (3.4, 7.4) | 3.8 (2.6, 5.7) | 0.193 |
| Lymphocyte count (×109·L−1) | 1.3 (0.9, 1.8) | 1.3 (0.9, 1.8) | – | – |
| NLR | 3.7 (2.4, 6.1) | 3.7 (2.4, 6.1) | – | – |
| Platelet count (×109·L−1) | 107.8 ± 52.4 | 114.4 ± 53.5 | 97.1 ± 48.6 | 0.500 |
| Serum potassium (mmol·L− 1) | 4.0 ± 0.6 | 4.0 ± 0.6 | 4.0 ± 0.5 | 0.051 |
| Serum sodium (mmol·L− 1) | 135.4 ± 4.8 | 135.4 ± 4.7 | 136.0 (133.0,138.0) | 0.961 |
| Serum creatinine (mg·dL− 1) | 69.2 (58.0, 83.9) | 66.8 (57.4, 82.1) | 72.0 (61.0, 84.8) | 0.061 |
| HBeAg positive rate (n/%) | 370 (54.1) | 265 (62.6) | 105 (40.2) | < 0.001 |
| HBV-DNA level (Log10 copies·mL−1) | 5.8 ± 1.5 | 5.8 ± 1.5 | 5.7 ± 1.7 | 0.601 |
| Mortality | ||||
| 28- day (n/%) | 175 (25.6) | 132 (31.2) | 43 (16.5) | < 0.001 |
| 90- day (n/%) | 251 (36.7) | 173 (40.9) | 78 (29.9) | 0.004 |
| Scoring systems | ||||
| CTP | 11 (10, 12) | 11 (10, 12) | 10 (9, 11) | < 0.001 |
| CLIF-ACLF | 38.6 ± 8.1 | 39.3 ± 18.8 | 37.6 ± 6.7 | < 0.001 |
| MELD | 22.9 (20.0, 26.5) | 22.6 (19.5, 26.5) | 23.3 (20.8, 27.0) | 0.065 |
| MELD-Na | 22.3 (18.1, 28.0) | 23.0 (18.9, 28.6) | 21.1 (17.0, 27.6) | 0.005 |
Data were presented as n (%), mean ± standard deviation, or median (interquartile range) as appropriate. ACLF acute-on chronic liver failure, HBV hepatitis B virus, NUCs nucleotide analogs, HE hepatic encephalopathy, ALT alanine aminotransferase, AST aspartate aminotransferase, TBIL total bilirubin, GGT gamma-glutamyl transpeptidase, ALP alkaline phosphatase, PTA prothrombin activity, INR international normalized ratio, NLR neutrophil to lymphocyte ratio, HBeAg hepatitis B e antigen, CTP Child-Turcotte-Pugh, CLIF-ACLF Chronic Liver Failure-ACLF, MELD model of end-stage liver disease, MELD-Na MELD integrating sodium