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 |
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| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Cirrhosis Bilirubin Systemic inflammation Severity of Illness Index Gastroenterology Sepsis chemistry.chemical_compound Ammonia Internal medicine medicine Humans Hepatic encephalopathy Creatinine Hepatology business.industry Acute-On-Chronic Liver Failure Prognosis medicine.disease Transplantation chemistry Hepatic Encephalopathy medicine.symptom business |
| Zdroj: | Hepatology International. 15:970-982 |
| ISSN: | 1936-0541 1936-0533 |
| DOI: | 10.1007/s12072-021-10221-7 |
| 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 |
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