Predicting 90-day mortality at admission and 7 days post-admission among patients with hepatitis B virus-related acute-on-chronic liver failure
Objective: To investigate the relationship between baseline characteristics and 90-day mortality in hepatitis B virus-related acute-on-chronic liver failure patients.
Methods: The retrospective study was conducted at Fuling Centre Hospital, Chongqing, China, and comprised data from July 2015 to June 2018 of hepatitis B virus-related acute-on-chronic liver failure patients. Demographic characteristics and clinical features at admission and 7 days post-admission were noted. The data was then divided into two groups based on a patient’s 90-day survival status, and their clinical and lab characteristics were compared using SPSS 16.
Results: Of the 120 patients screened, 100(83.3%) were included; 75(75%) males and 25(25%) females. The overall mean age was 50.04±14.61 years. There were 68(68%) in the surviving group and 32(432%) in the non-surviving group. Patients who had hyper-leukocytosis, hypoalbuminemia, lower prothrombin time activity, ascites, hepatic encephalopathy, higher alanine aminotransferase levels and renal dysfunction at admission had poor prognoses (p<0.05). At 7 days post-admission, the non-surviving group had lower platelet count, higher aspartate aminotransferase level, lower bilirubin normalisation rate and higher total bile acid levels (p<0.05).
Conclusions: Baseline organ failure severity was found to determine the outcome more strongly than the underlying cause.
Key Words: Hepatitis B, Acute-on-chronic liver failure, Prognosis.