Background: To evaluate the accuracy of two-dimensional (2D) shear wave elastography (SWE), develop and validate a novel prognostic model in predicting acute-on-chronic liver failure (ACLF) development in patients with acutely decompensated hepatitis B cirrhosis.
Methods: This prospective cohort study enrolled 221 patients in the First Affiliated Hospital of Nanchang University from September 2019 to January 2021, and randomly assigned them to the derivation and validation cohorts (7:3 ratio). Ultrasound, 2D SWE, clinical and laboratory data were collected, and outcome (ACLF developed) was recorded during a 90-day follow-up period. We evaluated the ability of 2D SWE to predict the outcome, developed a model for predicting ACLF development in the derivation cohort, and assessed the model in the validation cohort.
Results: 2D SWE values were significantly higher in patients with ACLF development (P<0.05). The accuracy of 2D SWE in predicting the outcome was better than that of serum parameters of liver fibrosis (all P<0.05). The SWE model for ACLF development had good calibration and discrimination [concordance index (C-index): 0.855 and 0.840 respectively] in derivation and validation cohorts, outperforming serum prognostic scores (all P<0.05).
Conclusions: The SWE model, superior to serum prognostic scores in predicting ACLF development, could be a noninvasive tool to guide the individual management of patients with acutely decompensated hepatitis B cirrhosis.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014136 | PMC |
| http://dx.doi.org/10.21037/qims-21-871 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A nomogram model based on albumin-bilirubin score for predicting 90-day prognosis in patients with acute-on-chronic liver failure.
Front Med (Lausanne)
January 2025
Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China.
Objective: To develop a nomogram model based on the albumin-bilirubin (ALBI) score for predicting the 90-day prognosis of patients with acute-on-chronic liver failure (ACLF) and to evaluate its predictive efficacy.
Methods: Clinical data of 290 ACLF patients at the Third People's Hospital of Nantong City, collected from December 2020 to December 2023, were analyzed. The data were divided into a training set ( = 200) and a validation set ( = 90), with August 2022 as the cut-off date.
AKI in ACLF: navigating the complex therapeutic puzzle.
Expert Rev Gastroenterol Hepatol
January 2025
Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi, India.
Introduction: Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is driven by the severity of systemic inflammation, acute portal hypertension driving circulatory dysfunction, hyperbilirubinemia, and toxicity of bile acids. The spectrum is mostly structural, associated with reduced response to vasoconstrictors. The progression is rapid, and need of renal replacement therapy and extracorporeal therapies may be required for the management.
View Article and Find Full Text PDFCirculating monocytes upregulate CD52 and sustain innate immune function in cirrhosis unless acute decompensation emerges.
J Hepatol
January 2025
Department of Biomedicine, University of Basel, Switzerland; University Centre for Gastrointestinal and Liver Disease Basel, Switzerland. Electronic address:
Background & Aims: Infectious complications determine the prognosis of cirrhosis patients. Their infection susceptibility relates to the development of immuneparesis, a complex interplay of different immunosuppressive cells and soluble factors. Mechanisms underlying the dynamics of immuneparesis of innate immunity remain inconclusive.
View Article and Find Full Text PDFArtificial Liver Support Systems in Acute Liver Failure and Acute-on-Chronic Liver Failure: Systematic Review and Meta-Analysis.
Crit Care Explor
January 2025
eGenesis, Inc., Cambridge, MA.
Objectives: To systematically review the safety and efficacy of nonbiological (NBAL) or biological artificial liver support systems (BAL) and whole-organ extracorporeal liver perfusion (W-ECLP) systems, in adults with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF).
Data Sources: Eligible NBAL/BAL studies from PubMed/Embase searches were randomized controlled trials (RCTs) in adult patients with ALF/ACLF, greater than or equal to ten patients per group, reporting outcomes related to survival, adverse events, transplantation rate, and hepatic encephalopathy, and published in English from January 2000 to July 2023. Separately, we searched for studies evaluating W-ECLP in adult patients with ALF or ACLF published between January1990 and July 2023.
Clinical evaluation of long-read sequencing-based episignature detection in developmental disorders.
Genome Med
January 2025
Laboratory of Cytogenetics and Genome Research, Centre for Human Genetics, KU Leuven, Leuven, 3000, Belgium.
Background: A subset of developmental disorders (DD) is characterized by disease-specific genome-wide methylation changes. These episignatures inform on the underlying pathogenic mechanisms and can be used to assess the pathogenicity of genomic variants as well as confirm clinical diagnoses. Currently, the detection of these episignature requires the use of indirect methylation profiling methodologies.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!