Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study

Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD based on the aetiol...

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Vydáno v:Annals of medicine (Helsinki) Ročník 57; číslo 1; s. 2428431
Hlavní autoři: Kim, Jung Hee, Kim, Sung-Eun, Song, Do Seon, Kim, Hee Yeon, Yoon, Eileen L., Park, Ji Won, Kim, Tae Hyung, Jung, Young-Kul, Suk, Ki Tae, Yim, Hyung Joon, Kwon, Jung Hyun, Lee, Sung Won, Kang, Seong Hee, Kim, Moon Young, Jeong, Soung Won, Jang, Jae-Young, Yoo, Jeong Ju, Kim, Sang Gyune, Jin, Young-Joo, Cheon, Gab Jin, Kim, Byung Seok, Seo, Yeon Seok, Kim, Hyoungsu, Sinn, Dong Hyun, Chung, Woo Jin, Kim, Hwi Young, Lee, Han Ah, Nam, Seung Woo, Kim, In Hee, Kim, Ji Hoon, Chae, Hee Bok, Sohn, Joo Hyun, Cho, Ju Yeon, Kim, Yoon Jun, Yang, Jin Mo, Park, Jung Gil, Kim, Won, Cho, Hyun Chin, Kim, Dong Joon
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Taylor & Francis 01.12.2025
Taylor & Francis Group
Témata:
acute decompensation
Acute-On-Chronic Liver Failure - epidemiology
Acute-On-Chronic Liver Failure - etiology
Acute-On-Chronic Liver Failure - mortality
Adult
aetiology
Aged
Chronic liver disease
Disease Progression
Female
Gastrointestinal Hemorrhage - etiology
Hepatitis, Viral, Human - complications
Hepatology
Humans
Hypertension, Portal - complications
Hypertension, Portal - etiology
liver cirrhosis
Liver Cirrhosis - etiology
Male
Middle Aged
Prognosis
Prospective Studies
Republic of Korea - epidemiology
Republic of Korea
aetiology
Chronic liver disease
acute decompensation
liver cirrhosis
ISSN:0785-3890, 1365-2060, 1365-2060
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Shrnutí:Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD based on the aetiology of CLD, encompassing LC. However, limited research has been conducted to analyse these discrepancies across aetiologies. The prospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort consisted of 1,501 patients who were hospitalized with AD of CLD from July 2015 to August 2018. In this study, we assess the clinical attributes and prognostic implications of AD with CLD/LC stratified by the aetiology. Among 1,501 patients, the mean age was 54.7 years old and 1,118 patients (74.5%) were men. The common events of AD were GI bleeding (35.3%) and jaundice (35.0%). There was a median follow-up of 8.0 months (1.0-16.0 months). The most common aetiology of CLD was alcohol (  = 1021), followed by viral hepatitis (  = 206), viral hepatitis with alcohol-related (  = 129), cryptogenic (  = 108) and autoimmune (  = 37). Viral hepatitis with alcohol-related CLD showed a poor liver function profile and a high frequency of acute-on-chronic liver failure (ACLF) [22.1% vs. 19.6% (alcohol CLD), 8.1% (viral CLD), 5.6% (autoimmune related CLD and 16.0% (cryptogenic CLD)] with worse adverse outcomes (mortality or liver transplantation) than other aetiologies. The difference in aetiology was a significant factor for 28-day adverse outcomes in multivariate analysis even in a high MELD score (≥15), which indicated poor baseline liver function and prognosis (  < 0.001). The aetiology of CLD constitutes a pivotal determinant influencing both short- and long-term adverse outcomes of AD in CLD, even among individuals presenting with elevated MELD scores. Notably, patients afflicted with viral hepatitis should exercise caution even in the consumption of modest quantities of alcohol that induced the exacerbations in the adverse outcomes associated with AD.
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Supplemental data for this article can be accessed online at https://doi.org/10.1080/07853890.2024.2428431.
ISSN:0785-3890
1365-2060
1365-2060
DOI:10.1080/07853890.2024.2428431