Abstract
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.
Original language | English |
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Pages (from-to) | 134-141 |
Number of pages | 8 |
Journal | Journal of Clinical Gastroenterology |
Volume | 53 |
Issue number | 2 |
DOIs | |
Publication status | Published - 2019 Feb 1 |
Bibliographical note
Publisher Copyright:© 2018 The Author(s). Published by Wolters Kluwer Health, Inc.
Keywords
- acute-on-chronic liver failure
- decompensation
- organ failure
- survival
ASJC Scopus subject areas
- Gastroenterology