Abstract

Background: Acute on chronic liver failure (ACLF) is associated with organ failures and high short-term mortality. Our objective was to determine the prevalence and the predictors of ACLF in cirrhotic patients hospitalized for acute decompensation.

Methods: Consecutive cirrhotic patients hospitalized for acute decompensation were recruited from January 2012 to December 2019. Logistic regression analyses were performed to identify clinical and epidemiological predictors of ACLF.

Results: In total, 195 patients were included. The mean age was 65.4 ± 13.1 years and the sex-ratio was 1.7. During follow-up, these patients were admitted to our department 460 times. ACLF occurred in 28.6% of admissions. Grade 1 was the most common (55.3%) followed by Grade 2 (22.7%) and Grade 3 (21.9%). The predictors of ACLF occurrence in our series were: bacterial infection (p < 0.001), CHILD-pugh score (p = 0.001), high MELD score on admission (p = 0,001), advanced age > 50 years (p = 0,02) and history of high blood pressure (p = 0,04). In multivariate analysis, only bacterial infection (p < 0.001, OR = 23.6), CHILD-pugh score (p = 0.02, OR = 20.3) MELD-Na and MELD score (p = 0.003, OR = 10.2) were independent predictors of ACLF.

Conclusion: In our study, the prevalence of ACLF was 28.6% of admissions. As a major precipitating factor, Bacterial infections would require rapid and effective management as well as close monitoring.

Keywords: Liver Cirrhosis; ACLF; Bacterial Infection; Prevalence; Predictors

References

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