Dynamic assessments of hepatic encephalopathy and ammonia levels predict mortality in acute-on-chronic liver failure

Autor: Dong Joon Kim, Ashok Choudhury, Guan H Lee, Pratima Rao, Ashok Kumar, Mamun Al Mahtab, Ajit Sood, George K. K. Lau, Diana A. Payawal, AS Butt, Jinhua Hu, Harshad Devarbhavi, Shiv Kumar Sarin, Manoj Kumar Sahu, Ashish Goel, Wasim Jafri, Soek Siam Tan, Qin Ning, Nipun Verma, V G Mohan Prasad, Ramesh Kumar, Vandana Midha, Ananta Shresta, Ayaskanta Singh, Sombat Treeprasertsuk, Akash Shukla, Nan Yuemin, A. Kadir Dokmeci, Han Tao, R. K. Dhiman, Jose D. Sollano, H. Ghazinyan, Sunil Taneja, Saeed Hamid, Duan Zhongping, Ajay Duseja, Anil Arora, Laurentius A. Lesmana, CE Eapen, Anand V. Kulkarni, Virender Singh, Samir Shah, Omesh Goyal, Xin Shaojie
Rok vydání: 2021
Předmět:
Zdroj: Hepatology International. 15:970-982
ISSN: 1936-0541
1936-0533
Popis: We evaluated the dynamics of hepatic encephalopathy (HE) and ammonia estimation in acute-on-chronic liver failure (ACLF) patients due to a paucity of evidence. ACLF patients recruited from the APASL-ACLF Research Consortium (AARC) were followed up till 30 days, death or transplantation, whichever earlier. Clinical details, including dynamic grades of HE and laboratory data, including ammonia levels, were serially noted. Of the 3009 ACLF patients, 1315 (43.7%) had HE at presentation; grades I–II in 981 (74.6%) and grades III–IV in 334 (25.4%) patients. The independent predictors of HE at baseline were higher age, systemic inflammatory response, elevated ammonia levels, serum protein, sepsis and MELD score (p
Databáze: OpenAIRE