Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Short-Term Mortality of Acute-on-Chronic Liver Failure

J Hepatol; ePub 2018 Dec 24; Hernaez, et al

In a US cohort of hospitalized patients with decompressed cirrhosis, acute-on-chronic liver failure (ACLF) is was common and associated with high short-term mortality. Researchers used the US Department of Veterans Affairs (VA) Corporate Data Warehouse to identify patients with ACLF during hospitalization for decompensated cirrhosis at any of the 127 VA hospitals between 2004 and 2014. The prevalence of ACLF and variables associated with 28- and 90-day mortality in ACLF were examined, along with trends in prevalence and survival over time. Among the findings:

  • Of 72,316 racially/ethnically diverse patients hospitalized for decompensated cirrhosis, 19,082 (26.4%) patients me the criteria of ACLF on admission.
  • Patients with ACLF had high 28- and 90-day mortality (25.5% and 40.02%, respectively).
  • Mortality risk increased in parallel with the number of organ failure and ranged from 17% to 53% at 28 days and from 31% to 69% at 90 days.
  • African American race and being seen at a transplant center were associated with lower risk of ACLF mortality.

Citation:

Hernaez R, Kramer JR, Liu Y, et al. Prevalence and short-term mortality of acute-on-chronic liver failure: A national cohort study from the USA. [Published online ahead of print December 24, 2018]. J Hepatol. doi:10.1016/j.jhep.2018.12.018.

This Week's Must Reads

Metachronous Neoplasia & Incomplete Polyp Resection, Clin Gastroenterol Hepatol; ePub 2019 Feb 12; Adler, et al

DNA Methylation Patterns in Crohn’s Disease, Gastroenterology; ePub 2019 Feb 16; Somineni, et al

Gender Differences in Patients Hospitalized with Cirrhosis, J Clin Gastroenterol; ePub 2019 Feb 22; Rubin, et al

POC Test for Identifying Viraemic HCV Infection, J Hepatol; ePub 2019 Feb 21; Freiman, et al

Must Reads in Endoscopy, Pancreas, & Biliary Tract

Gender Differences in Patients Hospitalized with Cirrhosis, J Clin Gastroenterol; ePub 2019 Feb 22; Rubin, et al

POC Test for Identifying Viraemic HCV Infection, J Hepatol; ePub 2019 Feb 21; Freiman, et al

Frailty in Patients with Ascites & Hepatic Encephalopathy, Gastroenterology; ePub 2019 Jan 19; Lai, et al

Hypercholesterolemia & Statin Exposure in Cirrhosis, Gastroenterology; ePub 2019 Jan 18; Kaplan, et al

Response to UDCA Treatment in PBC Patients, Clin Gastroenterol Hepatol; ePub 2019 Jan 4; Cheung, et al