Evidence map›Paper›PMID 34739590›Full record

ArticleJournal of gastroenterology2021

Nationwide survey for patients with acute-on-chronic liver failure occurring between 2017 and 2019 and diagnosed according to proposed Japanese criteria.

Nobuaki Nakayama, Hayato Uemura, Yoshihito Uchida, Yukinori Imai, Tomoaki Tomiya, Shuji Terai, Hitoshi Yoshiji, Takuya Genda, Akio Ido, Kazuaki Inoue and 14 more

Abstract read
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In one paragraph

Article in Journal of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Review
  2. Article
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  6. Observational
  7. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Nobuaki NakayamaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-Gun, 38 Morohongo, Moroyama-Machi, Saitama, 350-0495, Japan.
Hayato UemuraDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-Gun, 38 Morohongo, Moroyama-Machi, Saitama, 350-0495, Japan.
Yoshihito UchidaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-Gun, 38 Morohongo, Moroyama-Machi, Saitama, 350-0495, Japan.
Yukinori ImaiDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-Gun, 38 Morohongo, Moroyama-Machi, Saitama, 350-0495, Japan.
Tomoaki TomiyaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-Gun, 38 Morohongo, Moroyama-Machi, Saitama, 350-0495, Japan.
Shuji TeraiDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Hitoshi YoshijiDepartment of Gastroenterology, Nara Medical University, Nara, Japan.
Takuya GendaDepartment of Gastroenterology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan.
Akio IdoDepartment of Digestive and Life-Style Related Disease, Health Research Course, Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Kazuaki InoueDepartment of Gastroenterology, International University of Health and Welfare, Narita, Chiba, Japan.
Naoya KatoDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Isao SakaidaDepartment of Gastroenterology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Masahito ShimizuDepartment of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan.
Yasuhiro TakikawaDivision of Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
Masanori AbeDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
Ryuzo AbeDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Kazuaki ChayamaCollaborative Research Laboratory of Medical Innovation, Hiroshima University, Hiroshima, Japan.
Kiyoshi HasegawaDepartment of Surgery, Hepato-Biliary-Pancreatic Surgery Division, University of Tokyo, Tokyo, Japan.
Ayano InuiDepartment of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.
Mureo KasaharaTransplantation Center, National Center for Child Health and Development, Tokyo, Japan.
Hiromasa OhiraDepartment of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Atsushi TanakaDepartment of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Hajime TakikawaDepartment of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Satoshi MochidaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-Gun, 38 Morohongo, Moroyama-Machi, Saitama, 350-0495, Japan. smochida@saitama-med.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe significance of the 2018 Japanese diagnostic criteria for acute-on-chronic liver failure (ACLF) has not yet been evaluated.

methodsA nationwide survey was performed for patients with ACLF occurring between 2017 and 2019. Cirrhotic patients with a Child-Pugh score of 5-9 were diagnosed as having ACLF when liver failure (serum bilirubin level of ≥ 5.0 mg/dL and a prothrombin time international normalization rate [INR] of ≥ 1.5) occurred within 28 days after an acute insult. Patients who fulfilled either criterion (total serum bilirubin or INR) and/or those with indeterminate Child-Pugh scores at baseline were also enrolled.

resultsAmong the 501 enrolled patients, 183 patients (37%) were diagnosed as having ACLF. The etiologies of the cirrhosis and acute insults were alcohol intake/abuse in 114 (62%) and 75 (41%) patients, respectively. Sixty-eight patients (37%) were also diagnosed as having severe alcoholic hepatitis. The survival rate without liver transplantation was 48% among the ACLF patients and 71% in the remaining patients (P < 0.01). A multivariate analysis revealed that the disease condition was significantly associated with mortality, with an odds ratio of 2.025 in ACLF patients relative to the remaining patients (P < 0.01), and patient age and the number of organs with functional failure were also associated with mortality among the ACLF patients.

conclusionThe proposed diagnostic criteria for ACLF were useful for identifying cirrhotic patients with an unfavorable outcome following acute insults. A therapeutic strategy for patients with severe alcoholic hepatitis should be established, since such patients accounted for the majority of ACLF patients.

Indexed as

Acute-On-Chronic Liver FailureChildHumansJapanLiver CirrhosisOdds RatioPrognosisACLFAlcoholic hepatitisLiver transplantationMultiple organ failure

Identifiers

PMID34739590

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.