Dataset Information

Ammonia predicts poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure.

ABSTRACT:

Background

Hepatic encephalopathy (HE) is a common feature of acute liver failure and has been reported to be associated with poor outcomes. Ammonia is thought to be central to the pathogenesis of HE, but its role in hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is unclear. The present study aimed to assess the prognostic role of ammonia level for patients with HBV-ACLF.

Methods

We retrospectively recruited 127 patients diagnosed with HBV-ACLF for the present study.

Results

Ammonia levels at the time of admission were higher among non-surviving participants than in survivors. Increased ammonia level was found to be associated with severe liver disease and was identified as an independent predictor for mortality in patients with HBV-ACLF.

Conclusions

Our results suggest that high ammonia level at admission is an independent factor for predicting short-term mortality in patients with HBV-ACLF. Therefore, ammonia levels may represent a therapeutic target for this condition.

SUBMITTER: Zhang J

PROVIDER: S-EPMC7755815 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Ammonia predicts poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure.

Zhang JinFei J Liu XiaoLu X Ye Bo B Chen Hui H

Journal of clinical laboratory analysis 20200911 12

<h4>Background</h4>Hepatic encephalopathy (HE) is a common feature of acute liver failure and has been reported to be associated with poor outcomes. Ammonia is thought to be central to the pathogenesis of HE, but its role in hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is unclear. The present study aimed to assess the prognostic role of ammonia level for patients with HBV-ACLF.<h4>Methods</h4>We retrospectively recruited 127 patients diagnosed with HBV-ACLF for the present ...[more]

PMID: 32914901

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Project description:BackgroundInfection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in patients with HBV-ACLF defined by EASL in China.MethodsWe performed a retrospective cohort study in patients with HBV-ACLF defined by EASL in a single center from January 2015 to December 2017. These patients were divided into two groups with and without infection. The incidence, sites of infection, isolated strains, and risk factors associated with mortality were evaluated.ResultsA total of 289 patients were included, among them 185 (64.0%) were diagnosed with an infection. The most common type of infection was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P < 0.01), septic shock (P < 0.001), and ACLF-3 (P < 0.05). Also, patients with infection isolated one, two, and three or more strains showed a growing incidence of sepsis (P < 0.01) and septic shock (P < 0.001). Patients with infection showed a significantly higher 28-day mortality than those without (P < 0.01), especially in patients with ACLF-3. Infection was identified as an independent risk factor for 28-day mortality in all HBV-ACLF patients. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for patients with infection.ConclusionsInfection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased number of infection sites or isolated strains was associated with the occurrence of sepsis and septic shock. Pneumonia and sepsis were independent predictors for mortality in HBV-ACLF patients with infection.

Dataset Information

Ammonia predicts poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure.

Background

Methods

Results

Conclusions

Publications

Ammonia predicts poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure.

Similar Datasets

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