Prevalence and Risk Factors of Acute-on-Chronic Liver Failure at Sanglah General Hospital Denpasar Bali
Cokorda Agung Wahyu Purnamasidhi1, I Ketut Mariadi2 and I Dewa Nyoman Wibawa21Department of Internal Medicine, Udayana University/ Udayana University General Hospital, Bali.
2Department of Internal Medicine Division of Gastroenterology and Hepatology, Udayana University/Sanglah General Hospital, Bali
Corresponding Author E-mail: dewa_wibawa@unud.ac.id
Abstract: Background: Acute-on-chronic liver failure(ACLF) has been acknowledged as the suddenworsening of liver capacity in cirrhotic patients, which is typicallylinkedto a triggering factor and results in the collapse of at least one organ. ACLF has been known to be a highly mortal case. The reason for this investigation was to decide the incidence, features, risk factors and death at 30 days of individuals with ACLF. Method: The present study was conducted in Sanglah general hospital, included an amount of 110 cirrhotic patients whom admitted for hospitalizationamid the period of June 2016 and July 2017. ACLF diagnostic criteria by the European Association for the Study of the Liver-Chronic Liver Failure-Consortium was utilized. Our population was separated into the ACLF and non-ACLF group. Clinical feature, triggering occasions, possible risk factors for promoting ACLF and explanation for death were figured out. Mortality and causes of death at 30 days was assessed regarding the matter. Thirty-days mortality of the subjects was assessed. Results: Nine patients (8.2%) established ACLF. Bacterial infections were perceived as antriggering eventof 100% of cases ACLF with Pneumonia (44.4%) and Peritonitis (33.3%) as a center contamination. Contrasting the ACLF and non-ACLF group, statistically important features were: existence of hepatic encephalopathy in 9 (100%)vs30 (29.7%) (P < 0.01), leukocytosis of 19.34±1.97 x109vs7.74±3.93 x109 (P < 0.01) and nearness of ascites amid hospitalization 9 (100%) vs43 (42,5%)(P = 0.001). Death rate was 100% (9 patients) vs6.9% (7 patients), individually (P < 0.01). Conclusion: Our present study concluded that ACLF had a high mortality rate with noteworthyrisk factors are liver encephalopathy, leukocytosis and ascites.
Keywords: Acute-on-chronic liver failure; Cirrhosis; Mortality; Risk factors Back to TOC