26 September 2020: Database Analysis
Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF
Xinran Lin 1ABCDEF* , Xielin Huang 2ABCDEF* , Li Wang 1BC , Shuyi Feng 1B , Xiaofu Chen 1BC , Weimin Cai 1B , Zhiming Huang 1A*DOI: 10.12659/MSM.926574
Med Sci Monit 2020; 26:e926574
Table 1 Characteristics of cirrhotic patients in this study, stratified by mortality (n=786, day=28).
| Variables | All patients (n=786) [n (%)] | Survivors (n=559) [n (%)] | Nonsurvivors (n=227) [n (%)] | P value* |
|---|---|---|---|---|
| Demographic parameters | ||||
| Age (years) | 56 (50–65) | 56 (49–64) | 58 (50–67) | 0.093 |
| Sex (male) [n (%)] | 524 (66.7) | 374 (66.9) | 150 (66.1) | 0.050 |
| Height (cm) | 172.7 (165.1–178.0) | 172.7 (165.1–177.8) | 173.0 (163.0–179.1) | 0.647 |
| Weight (kg) | 84.6 (71.3–99.8) | 84.2 (71.1–100.0) | 85.0 (72.0–99.0) | 0.935 |
| Ethnicity[n (%)] | ||||
| White | 584 (74.3) | 427 (76.4) | 157 (69.2) | |
| Black | 61 (7.8) | 50 (8.9) | 11 (4.8) | |
| Other | 141 (17.9) | 82 (14.7) | 59 (26) | |
| Vital signs and treatment | ||||
| Heart rate | 89.2±16.8 | 87.9±16.3 | 92.4 ±17.6 | 0.001 |
| Respiratory rate (bpm) | 18 (16–21) | 18 (15–21) | 20 (17–23) | |
| Temperature (°C) | 36.7 (36.3–37.1) | 36.7 (36.4–37.2) | 36.4 (36.0–36.9) | |
| MAP (mmHg) | 73.7 (67.1–82.2) | 75.7 (69.5–84.5) | 69.4 (64.3–75.6) | |
| PaO2/FiO2 | 218 (133–367) | 241 (149–376) | 174 (99–329) | |
| SpO2/FiO2 | 194 (101–250) | 196 (137–250) | 162 (99–245) | |
| 24-h urine output (ml) | 1182.5 (582.0–1940.0) | 1360.0 (786.5–2118.5) | 656.5 (206.0–1338.5) | |
| Vasopressin used [n (%)] | 280 (35.6) | 156 (27.9) | 124 (54.6) | |
| Ventilator[n (%)] | 453 (57.6) | 308 (55.1) | 145 (63.9) | 0.024 |
| RRT [n (%)] | 68 (8.7) | 35 (6.3) | 33 (14.5) | |
| Cirrhosis complication [n (%)] | ||||
| Hepatic encephalopathy | 214 (27.2) | 142 (25.4) | 72 (31.7) | 0.071 |
| Ascites | 215 (27.4) | 139 (24.9) | 76 (33.5) | 0.014 |
| Variceal bleeding | 105 (13.4) | 69 (12.3) | 36 (15.9) | 0.189 |
| Spontaneous bacterial peritonitis | 68 (8.7) | 39 (7.0) | 29 (12.8) | 0.009 |
| Hepatorenal syndrome | 123 (15.6) | 63 (11.3) | 60 (26.4) | |
| Causes of cirrhosis [n (%)] | ||||
| Alcoholic | 411 (52.3) | 276 (49.4) | 135 (59.5) | 0.010 |
| Biliary | 17 (2.2) | 13 (2.3) | 4 (1.8) | 0.790 |
| Hepatitis B | 27 (3.4) | 15 (2.7) | 12 (5.3) | 0.069 |
| Hepatitis C | 259 (33) | 183 (32.7) | 76 (33.5) | 0.841 |
| Autoimmune | 12 (1.5) | 9 (1.6) | 3 (1.3) | 1.000 |
| Other | 189 (24) | 132 (23.6) | 57 (25.1) | 0.656 |
| ACLF [n (%)] | 196 (24.9) | 108 (19.3) | 88 (38.8) | |
| Diabetes | 227 (28.9) | 164 (29.3) | 63 (27.8) | 0.657 |
| Hypertension | 294 (37.4) | 216 (38.6) | 78 (34.4) | 0.261 |
| Diagnosis at ICU admission | ||||
| Acute respiratory failure | 278 (35.4) | 152 (27.2) | 126 (55.5) | |
| Acute renal failure | 425 (54.1) | 252 (45.1) | 173 (76.2) | |
| Cardiorespiratory arrest | 19 (2.4) | 5 (0.9) | 14 (6.2) | |
| Congestive heart failure | 138 (17.6) | 96 (17.2) | 42 (18.5) | 0.657 |
| Neurological failure | 95 (12.1) | 70 (12.5) | 25 (11.0) | 0.556 |
| Severe sepsis | 197 (25.1) | 86 (15.4) | 111 (48.9) | |
| Variceal bleeding | 105 (13.4) | 69 (12.3) | 36 (15.9) | 0.189 |
| Length of ICU stay | 3.48 (1.90–7.02) | 3.24 (1.89–7.02) | 3.83 (1.90–7.08) | 0.600 |
| * Student’s t-test or Mann-Whitney U-test was used for continuous variables, and χ-test or Fisher’s exact test was used for categorical variables. MAP – mean arterial pressure; RRT – renal replacement therapy. | ||||