Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors
- 주제(키워드) acute-on-chronic liver failure , decompensation , organ failure , survival
- 주제(기타) Gastroenterology & Hepatology
- 설명문(일반) [Yoon, Eileen L.] Inje Univ, Dept Internal Med, Goyang, South Korea; [Kim, Tae Yeob] Catholic Univ Daegu, Sch Med, Inst Med Sci, Daegu, South Korea; [Sohn, Joo Hyun] Catholic Univ Daegu, Sch Med, Dept Internal Med, Daegu, South Korea; [Kim, Tae Hun] Ewha Womans Univ, Sch Med, Dept Internal Med, Seoul, South Korea; [Kim, Hee Yeon; Kim, Chang Wook; Song, Do Seon; Yang, Jin Mo] Catholic Univ Korea, Dept Internal Med, Seoul, South Korea; [Sinn, Dong Hyun] Samsung Med Ctr, Dept Internal Med, Seoul, South Korea; [Kim, Jeong Han; Choe, Won Hyeok] Konkuk Univ, Dept Internal Med, Seoul, South Korea; [Jeong, Soung Won] Soonchunhyang Univ, Dept Internal Med, Seoul, South Korea; [Lee, Chang Hyeong] Catholic Univ Daegu, Sch Med, Dept Internal Med, Daegu, South Korea; [Cho, Hyun Chin; Lee, Sang Soo] Gyeongsang Natl Univ, Dept Internal Med, Jinju, South Korea; [Kim, Sung Eun; Kim, Hyoung Su; Kim, Dong Joon] Hallym Univ, Dept Internal Med, Coll Med, Chunchon, South Korea; [Jung, Young Kul; Yim, Hyung Joon] Korea Univ, Dept Internal Med, Ansan, South Korea; [Lee, Byung Seok] Chungnam Natl Univ, Dept Internal Med, Daejeon, South Korea; [Kim, Moon Young] Yonsei Univ, Dept Internal Med, Wonju Coll Med, Wonju, South Korea; [Choi, Eunhee] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Smith Ctr Outcomes Res Cardiol, Boston, MA USA
- 등재 SCIE, SCOPUS
- OA유형 Green Published, hybrid
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2019
- URI http://www.dcollection.net/handler/ewha/000000159994
- 본문언어 영어
- Published As http://dx.doi.org/10.1097/MCG.0000000000000987
- PubMed https://pubmed.ncbi.nlm.nih.gov/29369242
초록/요약
Goals: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). Background: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. Study: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed. ACLF was defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium definition. Results: The mean follow-up duration was 19.4 +/- 9.9 months. In the subgroup of patients without previous acute decompensation (AD), ACLF occurrence did not affect long-term outcomes. However, in patients with previous AD, ACLF negatively affected long-term transplant-free survival even after overcoming ACLF (hazard ratio, 2.00, P=0.012). Previous AD was the significant predictive factor of long-term mortality and was independent of the Model for End-stage Liver Disease score in these ACLF-surviving patients. Organ failure severity did not affect transplant-free survival in patients who survived an ACLF episode. Conclusions: A prior history of AD is the most important factor affecting long-term outcomes following an ACLF episode regardless of Model for End-stage Liver Disease score. Prevention of a first AD episode may improve the long-term transplant-free survival of liver cirrhosis patients.
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