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Patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF) show high morbidity and mortality. Independent prognostic predictors of short-term HBV-ACLF mortality include the Child-Turcotte-Pugh (CTP) score, the model for end-stage liver disease (MELD) score, other MELD-based indices and the dynamic changes in these indices. The aims of this study were to evaluate the existing prognostic scores in a large cohort of HBV-ACLF patients and create a new predictive model. We retrospectively reviewed 392 HBV-ACLF patients from December 2008 to November 2011 and evaluated their 3-month survival. The predictive accuracy of CTP, MELD and MELD-based indices and the dynamic changes in the MELD-related scores (Δ scoring systems) upon admission and after two weeks of treatment were compared using the area under the receiver operating characteristic (ROC) curve method. Life-threatening factors and a series of bio-clinical parameters were studied by univariate and multivariate analyses. Among the existing scores, MELD had the best predictive ability. However, our new regression model provided an area under the curve of 0.930 ± 0.0161 (95% CI: 0.869 to 0.943), which was significantly larger than that obtained with the MELD score at admission and after two weeks of treatment as well as with the dynamic changes of the MELD score (0.819, 0.921, and 0.826, respectively) (Z=3.542, P=0.0004). In a large cohort of patients retrospectively reviewed for this study, our prognostic model was superior to the MELD score and is, therefore, a promising predictor of short-term survival in patients with HBV-ACLF.
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http://dx.doi.org/10.1007/s11596-015-1394-5 | DOI Listing |
J Viral Hepat
January 2025
Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey.
In coronavirus disease 2019 (COVID-19), older age and co-morbidities are associated with mortality. Among liver disease aetiologies alcoholic liver disease was associated with mortality. Chronic hepatitis delta (CHD) had not been studied.
View Article and Find Full Text PDFBest Pract Res Clin Gastroenterol
December 2024
Aster Integrated Liver Care, Aster Medcity, Kochi, India.
Acute liver failure (ALF) is a rare and dynamic syndrome occurring as a sequela of severe acute liver injury (ALI). Its mortality ranges from 50% to 75% based on the aetiology, patients age and severity of encephalopathy at admission. With improvement in intensive care techniques, transplant-free survival in ALF has improved over time.
View Article and Find Full Text PDFDiscov Oncol
December 2024
Department of Hepatobiliary and Pancreatic Surgery, Dongguan People's Hospital, Dongguan, 523059, China.
Purpose: This study aim is to evaluate the application of stored autologous blood transfusion in liver cancer surgery and explore its impact on postoperative changes in inflammatory factors and liver function recovery.
Method: The study used a control group (CG) design and included 150 patients who underwent liver cancer surgery. While the observation group (OG) got autologous blood that had been preserved, the CG had a standard allogeneic blood transfusion.
Clin Exp Hepatol
September 2024
Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland.
Aim Of The Study: To assess the real-life efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) in HIV/HCV- positive patients treated with bictegravir/emtricitabine/tenofovir alafenamide (B/FTC/TAF).
Material And Methods: Patients were evaluated in terms of their baseline biochemical characteristics, which included platelet count, serum creatinine and bilirubin levels, alanine transaminase (ALT) activity, international normalized ratio (INR) and Model for End-Stage Liver Disease (MELD) score.The efficacy endpoint was the achievement of a sustained virologic response at posttreatment week 12 (SVR12), defined as undetectable HCV RNA 12 weeks after the scheduled end of therapy.
J Gastroenterol Hepatol
December 2024
Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Background And Aim: Prognosis in autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) has historically been poor. This multicenter retrospective cohort study investigated the natural history and assessed the predictors of outcomes in patients with AIH, PBC, and PSC.
Methods: AIH, PBC, and PSC patients were identified from the state-wide Hepascore and Clinical Outcome cohort.
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