ArticleWorld journal of hepatology2017
Acute-on-chronic liver failure in a multi-ethnic Asian city: A comparison of patients identified by Asia-Pacific Association for the Study of the Liver and European Association for the Study of the Liver definitions.
Article in World journal of hepatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Bone Marrow Mesenchymal Stem Cells in Acute-on-Chronic Liver Failure Grades 2 and 3: A Phase I-II Randomized Clinical Trial.Canadian journal of gastroenterology & hepatology · 2021Trial
- Liver Failure versus Organ Failure in Acute-on-Chronic Liver Failure: Sequence and Consequence.Gut and liver · 2026Article
- Beyond the Tipping Point: Advances in the Diagnosis and Management of Acute-on-Chronic Liver Failure and End-Stage Liver Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Dynamic inflammation-based prognostication in acute-on-chronic liver failure: The COSSH-CAR model as a step forward in personalized risk stratification.World journal of hepatology · 2026Article
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- Liver Transplantation in the Context of Acute-On-Chronic Liver Failure (ACLF): Where Do We Stand in 2025?Transplant international : official journal of the European Society for Organ Transplantation · 2025Review
- The Predictive Role of FGF21 in Acute Liver Injury Caused by Bacterial Infectious Diseases in Critical Care: A Retrospective Cohort Study.Journal of inflammation research · 2025Article
- Acute-on-chronic liver failure in metabolic dysfunction-associated fatty liver disease patients: a disease multiplier.Hepatology international · 2024Review
- Acute-on-chronic liver failure: Terminology, mechanisms and management.Clinical and molecular hepatology · 2023Review
- Acute-on-chronic liver failure: Controversies and consensus.World journal of gastroenterology · 2023Review
- A prognostic model of acute-on-chronic liver failure based on sarcopenia.Hepatology international · 2022Article
- Nationwide survey for patients with acute-on-chronic liver failure occurring between 2017 and 2019 and diagnosed according to proposed Japanese criteria.Journal of gastroenterology · 2021Article
- Predictors of early mortality among patients with acute-on-chronic liver failure.JGH open : an open access journal of gastroenterology and hepatology · 2021Article
- Ammonia predicts poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure.Journal of clinical laboratory analysis · 2020Article
- Management of acute-on-chronic liver failure: an algorithmic approach.Hepatology international · 2018Review
- A Case of Live Donor Liver Transplantation in Acute-on-Chronic Liver Failure with Budd-Chiari Syndrome: Donor and Recipient with Antiphospholipid Antibody Syndrome.The American journal of case reports · 2018Article
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Authors and funding
10 authors.
Funding
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Abstract
aimTo explore the applicability of the Asia-Pacific Association for the Study of the Liver (APASL) and European Association for the Study of the Liver (EASL) guidelines for acute-on-chronic liver failure (ACLF) in profiling patients and determining the outcome.
methodsPatients admitted to a tertiary hospital in Singapore with acute decompensation of liver disease from January 2004 to July 2014 are screened for ACLF according to the APASL and EASL criteria. The patients' data (including basic demographics, information about existing chronic liver disease, information about the acute decompensation, relevant laboratory values during admission, treatment, and outcome) are retrospectively analyzed to determine the background, precipitating factors and outcome.
resultsA total of 458 liver patients is analyzed, and 78 patients with ACLF are identified. Sixty-three patients (80.8%) meet the APASL criteria, 64 patients (82.1%) meet the EASL criteria, and 49 patients (62.8%) fulfilled both criteria. The most common causes of acute liver injury are bacterial infections (59.0%), hepatitis B flare (29.5%), and variceal bleeding (24.4%). The common aetiologies of the underlying chronic disease included hepatitis B (43.6%), alcoholic (20.5%) and cryptogenic (11.5%) liver disease. The overall mortality rate is 61.5%. Increased age, the number of organ failures (as per CLIF-SOFA score), peak creatinine, INR, and amylase levels are associated with increased mortality or the need for liver transplantation. 14.3% of patients undergo liver transplantation with a 100% 1-year survival rate.
conclusionBoth APASL and EASL criteria have identified ACLF patients with high three-month mortality, but those who fulfill APASL criteria alone have a better survival.
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