ArticleHepatology international2019
Complications constitute a major risk factor for mortality in hepatitis B virus-related acute-on-chronic liver failure patients: a multi-national study from the Asia-Pacific region.
Article in Hepatology international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Pooled it
- A global consensus on the critical care management of acute-on-chronic liver failure patients: the APASL ACLF Beijing Position Paper.Hepatology international · 2026Article
- Severe hepatitis B flare and liver failure: current assessment and management.Clinical and molecular hepatology · 2026Review
- A Systemic Inflammation Response Index (SIRI)-based nomogram for predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure: a retrospective cohort study.BMC gastroenterology · 2026Article
- Impact of artificial liver plasma perfusion combined with plasma exchange therapy on clinical efficacy and short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure with or without HIV infection.BMC infectious diseases · 2025Article
- Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review.Pathogens (Basel, Switzerland) · 2025Review
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- Clinical Utility of the Trajectory of Serum Bilirubin and International Normalized Ratio Values in Hepatitis B Virus-Related Acute-on-Chronic Liver Failure.International journal of general medicine · 2025Article
- Association Between Artificial Liver Support System and Prognosis in Hepatitis B Virus-Related Acute-on-Chronic Liver Failure.Infection and drug resistance · 2025Article
- Analysis of Efficacy and Safety of Small-Volume-Plasma Artificial Liver Model in the Treatment of Acute-On-Chronic Liver Failure.Physiological research · 2023Article
- Progress on clinical prognosis assessment in liver failure.Liver research (Beijing, China) · 2023Review
- Genetic landscape and immune mechanism of monocytes associated with the progression of acute-on-chronic liver failure.Hepatology international · 2023Article
- Clinical practice guidelines for acute-on-chronic liver failure: are we ready for reaching global consensus?Hepatobiliary surgery and nutrition · 2023Article
- Definition and classification of acute-on-chronic liver diseases.World journal of clinical cases · 2022Review
- Animal models applied to acute-on-chronic liver failure: Are new models required to understand the human condition?World journal of clinical cases · 2022Review
- Establishment and validation of a prognostic model for hepatitis B virus‑related acute-on-chronic liver failure patients with bacterial infection.Hepatology international · 2022Article
- Prognosis prediction performs better in patients with non-cirrhosis hepatitis B virus-related acute-on-chronic liver failure than those with cirrhosis.Frontiers in microbiology · 2022Article
- Design for a Multicentre Prospective Cohort for the Assessment of Platelet Function in Patients with Hepatitis-B-Virus-Related Acute-on-Chronic Liver Failure.Clinical epidemiology · 2022Article
- Liver Transplantation in Acute-on-Chronic Liver Failure: Excellent Outcome and Difficult Posttransplant Course.Frontiers in surgery · 2022Article
- HBV-related acute-on-chronic liver failure with underlying chronic hepatitis has superior survival compared to cirrhosis.European journal of gastroenterology & hepatology · 2021Article
Corrections and comments
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Authors and funding
32 authors at 20 institutions in 9 countries.
Funding
Abstract
BACKGROUND AND
aimCirrhosis is a controversial determinant of mortality in HBV-related acute-on-chronic liver failure (HBV-ACLF). The present study aimed to explore the effects of cirrhosis and the associated risk factors, especially its complications, on the outcome of HBV-ACLF.
methodsA prospective-retrospective cohort of 985 patients was identified from the APASL-ACLF Research Consortium (AARC) database and the Chinese Study Group. Complications of ACLF (ascites, infection, hepatorenal syndrome, hepatic encephalopathy, upper gastrointestinal bleeding) as well as cirrhosis and the current main prognostic models were measured for their predictive ability for 28- or 90-day mortality.
resultsA total of 709 patients with HBV-ACLF as defined by the AARC criteria were enrolled. Among these HBV-ACLF patients, the cirrhotic group showed significantly higher mortality and complications than the non-cirrhotic group. A total of 36.1% and 40.1% of patients met the European Association for the Study of Liver (EASL)-Chronic Liver Failure consortium (CLIF-C) criteria in the non-cirrhotic and cirrhotic groups, respectively; these patients had significantly higher rates of mortality and complications than those who did not satisfy the CLIF-C criteria. Furthermore, among patients who did not meet the CLIF-C criteria, the cirrhotic group exhibited higher mortality and complication rates than the non-cirrhotic group, without significant differences in organ failure. The Tongji prognostic predictor model score (TPPMs), which set the number of complications as one of the determinants, showed comparable or superior ability to the Chinese Group on the Study of Severe Hepatitis B-ACLF score (COSSH-ACLFs), APASL-ACLF Research Consortium score (AARC-ACLFs), CLIF-C organ failure score (CLIF-C OFs), CLIF-C-ACLF score (CLIF-C-ACLFs), Model for End-Stage Liver Disease score (MELDs) and MELD-sodium score (MELD-Nas) in HBV-ACLF patients, especially in cirrhotic HBV--ACLF patients. Patients with two (OR 4.70, 1.88) or three (OR 8.27, 2.65) complications had a significantly higher risk of 28- or 90-day mortality, respectively.
conclusionThe presence of complications is a major risk factor for mortality in HBV-ACLF patients. TPPM possesses high predictive ability in HBV-ACLF patients, especially in cirrhotic HBV-ACLF patients.
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