CLINICS

Clinics (Sao Paulo). 2017 November; 72(11): 686-692.
doi:10.6061/clinics/2017(11)07

Copyright © 2017 CLINICS

Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Qing Lei I # , Kangjian Ao I # , Yinhua Zhang I , Deqiang Ma I , Deping Ding I , Changzheng Ke I , Yue Chen I , Jie Luo III * , Zhongji Meng I II *

Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Hubei, Shiyan, 442000, China

Institute of Biomedical Research, Taihe Hospital, Hubei University of Medicine, Hubei, Shiyan, 442000, China

Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Hubei, Shiyan, 442000, China

*Corresponding author. E-mail: zhongji.meng@163.com / jie.luo@aliyun.com

#These authors contributed equally to this work.

received March 20, 2017; revised June 19, 2017; accepted August 14, 2017.

Abstract

OBJECTIVE:

To investigate the impact of the baseline status of patients with hepatitis B virus-associated acute-on-chronic liver failure on short-term outcomes.

METHODS:

A retrospective study was conducted that included a total of 138 patients with hepatitis B virus-associated acute-on-chronic liver failure admitted to the Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, from November 2013 to October 2016. The patients were divided into a poor prognosis group (74 patients) and a good prognosis group (64 patients) based on the disease outcome. General information, clinical indicators and prognostic scores of the patients’ baseline status were analyzed, and a prediction model was established accordingly.

RESULTS:

Elder age, treatment with artificial liver support systems and the frequency of such treatments, high levels of white blood cells, neutrophils, neutrophil count/lymphocyte count ratio, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, urea, and prognostic scores as well as low levels of albumin and sodium were all significantly associated with the short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure. The predictive model showed that logit (p) = 3.068 + 1.003 × neutrophil count/lymphocyte count ratio - 0.892 × gamma-glutamyl transferase - 1.138 × albumin - 1.364 × sodium + 1.651 × artificial liver support therapy.

CONCLUSION:

The neutrophil count/lymphocyte count ratio and serum levels of gamma-glutamyl transferase, albumin and sodium were independent risk factors predicting short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure, and the administration of multiple treatments with artificial liver support therapy during the early stage is conducive to improved short-term outcomes.

Keywords: Hepatitis B Virus, Acute-on-Chronic Liver Failure, Prognosis


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