Table 1.
Baseline characteristics of patients with acute-on-chronic liver failure
| Characteristics | Overall (n = 1,621) | Cirrhosis (n = 637) | Non-cirrhosis (n = 984) | p-value |
|---|---|---|---|---|
| Age (years) | 44.0 ± 11.9 | 44.0 ± 10.7 | 45.0 ± 12.5 | 0.040 |
| Male, n (%) | 1,405 (86.7%) | 576 (90.4%) | 829 (84.2%) | < 0.0001 |
| CLD etiologies | N = 1460 | N = 631 | N = 829 | |
| Alcohol | 858 (58.8%) | 423 (67.0%) | 435 (52.5%) | < 0.0001 |
| HBV | 274 (18.8%) | 98 (15.5%) | 176 (21.2%) | 0.007 |
| HCV | 42 (2.9%) | 10 (1.6%) | 32 (3.9%) | 0.011 |
| NASH | 81 (5.5%) | 37 (5.9%) | 44 (5.3%) | 0.646 |
| Cryptogenic | 144 (9.9%) | 37 (5.9%) | 107 (12.9%) | < 0.0001 |
| Other causesa | 61 (4.2%) | 26 (4.1%) | 35 (4.2%) | 1.000 |
| Acute insults | N = 1525 | N = 607 | N = 918 | |
| Alcohol | 783 (51.3%) | 382 (62.9%) | 401 (43.7%) | < 0.0001 |
| HBV reactivation | 260 (17.0%) | 75 (12.4%) | 185 (20.2%) | < 0.0001 |
| Drug-induced | 126 (8.3%) | 46 (7.6%) | 80 (8.7%) | 0.449 |
| Acute HEV | 62 (4.1%) | 28 (4.6%) | 34 (3.7%) | 0.427 |
| Other viral hepatitis | 68 (4.5%) | 24 (4.0%) | 44 (4.8%) | 0.527 |
| Infection-related | 30 (2.0%) | 0 (0%) | 30 (3.3%) | < 0.0001 |
| Autoimmune hepatitis | 48 (3.1%) | 21 (3.5%) | 27 (2.9%) | 0.653 |
| Other causesb | 16 (1.0%) | 3 (0.5%) | 13 (1.4%) | 0.122 |
| Cryptogenic | 68 (4.5%) | 21 (3.5%) | 47 (5.1%) | 0.130 |
| CTP score on admission | 11.8 ± 1.5 | 11.5 ± 1.4 | 12.0 ± 1.6 | < 0.0001 |
| MELD score on admission | 29.3 ± 7.1 | 28.6 ± 6.2 | 30.0 ± 7.5 | 0.001 |
| Number of organs failure | 1.68 ± 1.1 | 1.6 ± 1.0 | 1.7 ± 1.0 | 0.001 |
| No organ failure | 182 (11.2%) | 74 (11.6%) | 108 (11.0%) | |
| One organ failure | 595 (36.7%) | 263 (41.3%) | 332 (33.7%) | |
| Two organ failure | 505 (31.2%) | 186 (29.2%) | 319 (32.4%) | |
| Three organ failure | 256 (15.8%) | 91 (14.3%) | 165 (16.8%) | |
| Four organ failure | 70 (4.3%) | 20 (3.1%) | 50 (5.1%) | |
| Five organ failure | 12 (0.7%) | 3 (0.5%) | 9 (0.9%) | |
| Six organ failure | 1 (0.1%) | 0 (0%) | 1 (0.1%) | |
| Specific organs failure | ||||
| Hepatic encephalopathy | 759 (46.8%) | 248 (38.9%) | 511 (51.9%) | < 0.0001 |
| Coagulation | 573 (35.3%) | 173 (27.2%) | 400 (40.7%) | < 0.0001 |
| Renal | 376 (23.2%) | 106 (16.6%) | 270 (27.4%) | < 0.0001 |
| Circulatory | 60 (3.7%) | 16 (2.5%) | 44 (4.5%) | 0.004 |
| Respiratory | 224 (13.8%) | 144 (22.6%) | 80 (8.1%) | < 0.0001 |
| Liver failure | 1294 (79.8%) | 505 (79.3%) | 789 (80.2%) | 0.660 |
| Baseline laboratories | ||||
| Hemoglobin, g/dL | 10.6 ± 2.2 | 10.6 ± 2.1 | 10.5 ± 2.4 | 0.756 |
| WBC count, 109/L | 14.3 ± 9.3 | 14.1 ± 9.0 | 14.4 ± 9.5 | 0.646 |
| Platelet count, 109/L | 145.8 ± 89.4 | 147.8 ± 91.0 | 144.5 ± 88.4 | 0.470 |
| Serum sodium, mEq/L | 131.0 ± 8.1 | 130.0 ± 7.0 | 132.0 ± 8.6 | < 0.0001 |
| Creatinine, mg/dL | 1.6 ± 1.6 | 1.3 ± 1.2 | 1.8 ± 1.7 | < 0.0001 |
| Total bilirubin, mg/dL | 21.5 ± 9.8 | 21.5 ± 9.9 | 21.6 ± 9.8 | 0.817 |
| Albumin, g/dL | 2.3 ± 0.7 | 2.2 ± 0.6 | 2.4 ± 0.7 | < 0.0001 |
| ALT, U/L | 203.5 ± 454.5 | 126.0 ± 257.0 | 254.0 ± 541.0 | < 0.0001 |
| INR | 2.6 ± 1.2 | 2.3 ± 0 .8 | 2.7 ± 1.3 | < 0.0001 |
| Length of hospital stay (days) | 17.5 ± 14.1 | 18.0 ± 14.2 | 17.2 ± 14.0 | 0.243 |
| Mortality rate | ||||
| 28-days | 637 (39.3%) | 169 (26.5%) | 468 (47.6%) | < 0.0001 |
| 90-days | 809 (49.9%) | 245 (38.5%) | 564 (57.3%) | < 0.0001 |
ALT alanine aminotransferase, CLD chronic liver disease, CTP Child-Turcotte-Pugh score, HE hepatic encephalopathy, HCV hepatitis C virus, HEV; hepatitis E virus, INR international normalized ratio, MELD model for end-stage liver disease, WBC white blood cell count
aAutoimmune hepatitis, primary biliary cholangitis, Wilsons disease and cholestatic liver diseases
bViral hepatitis (HAV, HDV, HEV, EBV), autoimmune hepatitis, acute Wilsons disease, infection-induced (sepsis, spontaneous bacterial peritonitis, malaria, leptospirosis) and post-surgery