| ISSN |
2307-8960 (online) |
| Open Access |
This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ |
| Copyright |
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. |
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| Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
| Website |
http://www.wjgnet.com |
| Category |
Gastroenterology & Hepatology |
| Manuscript Type |
Retrospective Cohort Study |
| Article Title |
Acute-on-chronic liver failure is independently associated with higher mortality for cirrhotic patients with acute esophageal variceal hemorrhage: Retrospective cohort study
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| Manuscript Source |
Invited Manuscript |
| All Author List |
Alana Zulian Terres, Rafael Sartori Balbinot, Ana Laura Facco Muscope, Morgana Luisa Longen, Bruna Schena, Bruna Teston Cini, Gilberto Luis Rost Jr, Juline Isabel Leichtweis Balensiefer, Louise Zanotto Eberhardt, Raul Angelo Balbinot, Silvana Sartori Balbinot and Jonathan Soldera |
| ORCID |
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| Funding Agency and Grant Number |
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| Corresponding Author |
Jonathan Soldera, MD, MSc, Associate Professor, Staff Physician, Department of Gastroenterology, University of South Wales, 8 Forest Grove, Treforest, Pontypridd, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com |
| Key Words |
Gastrointestinal hemorrhage; Prognosis; Esophageal and gastric varices; Liver cirrhosis; Acute-on-chronic liver failure; Organ dysfunction scores |
| Core Tip |
Acute esophageal variceal hemorrhage (AEVH) is a common complication of cirrhosis and might precipitate multi-organ failure, causing acute-on-chronic liver failure (ACLF). The purpose of this study is to analyze if the presence and grading of ACLF as defined by European Society for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) is able to predict mortality in cirrhotic patients presenting AEVH. This is a retrospective cohort study executed in Hospital Geral de Caxias do Sul, which gathered data from medical records from 2010 to 2016 were obtained by searching the hospital electronic database for patients who received terlipressin. Medical records were reviewed in order to determine the diagnosis of cirrhosis and AEVH, including 97 patients. Kaplan-Meier survival analysis was used for univariate analysis and a stepwise approach to the Cox regression for multivariate analysis. All- cause mortality for AEVH patients was 36%, 40.2% and 49.4% for 30-, 90- and 365-day, respectively. The prevalence of ACLF was 41.3%. Of these, 35% grade 1, 50% grade 2 and 15% grade 3. In multivariate analysis, the non-use of non-selective beta-blockers, presence and higher grading of ACLF and higher Model for End-Stage Liver Disease scores were independently associated with higher mortality for 30-day with the addition of higher Child-Pugh scores for 90-day period. In conclusion, the presence and grading of ACLF according to the EASL-CLIF criteria was independently associated with higher 30- and 90-day mortality in cirrhotic patients admitted due to AEVH. |
| Publish Date |
2023-06-12 08:16 |
| Citation |
Terres AZ, Balbinot RS, Muscope ALF, Longen ML, Schena B, Cini BT, Rost Jr GL, Balensiefer JIL, Eberhardt LZ, Balbinot RA, Balbinot SS, Soldera J. Acute-on-chronic liver failure is independently associated with higher mortality for cirrhotic patients with acute esophageal variceal hemorrhage: Retrospective cohort study. World J Clin Cases 2023; 11(17): 4003-4018 |
| URL |
https://www.wjgnet.com/2307-8960/full/v11/i17/4003.htm |
| DOI |
https://dx.doi.org/10.12998/wjcc.v11.i17.4003 |
