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

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

Background 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. Methods ACLF patients recruited from the APASL-ACLF Research Consortium (AARC) were followed up till 30 days, death or transplant...

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Veröffentlicht in:Hepatology international 2021-08, Vol.15 (4), p.970-982
Hauptverfasser: Verma, Nipun, Dhiman, Radha Krishan, Choudhury, Ashok, Taneja, Sunil, Duseja, Ajay, Singh, Virender, Al Mahtab, Mamun, Devarbhavi, Harshad, Shukla, Akash, Ning, Q., Hamid, Saeed Sadiq, Butt, Amna Shubhan, Jafri, Wasim, Tan, Soek Siam, Hu, Jinhua, Zhongping, Duan, Treeprasertsuk, Sombat, Lee, Guan H., Ghazinyan, Hasmik, Lesmana, Laurentius A., Sood, Ajit, Midha, Vandana, Goyal, Omesh, Kim, Dong Joon, Eapen, C. E., Goel, Ashish, Tao, Han, Shaojie, Xin, Yuemin, Nan, Dokmeci, A. Kadir, Sahu, Manoj, Singh, Ayaskanta, Arora, Anil, Kumar, Ashish, Kumar, Ramesh, Prasad, V. G. Mohan, Shresta, Ananta, Sollano, Jose, Payawal, Diana Alcantara, Shah, Samir, Rao, P. N., Kulkarni, Anand, Lau, George K., Sarin, Shiv Kumar
Format: Artikel
Sprache:eng
Schlagworte:
Ammonia
Bilirubin
Colorectal Surgery
Consortia
Creatinine
Hepatic encephalopathy
Hepatology
Inflammation
Inflammatory response
Lactic acid
Liver
Liver failure
Medicine
Medicine & Public Health
Mortality
Original Article
Patients
Sepsis
Serum proteins
Surgery
Transplantation
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Zusammenfassung:Background 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. Methods 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. Results 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  
ISSN:1936-0533
1936-0541
DOI:10.1007/s12072-021-10221-7