ArticleBMC infectious diseases2025
Phase characteristics and risk factors of acute-on-chronic liver failure with invasive pulmonary aspergillosis.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Efficacy of glucocorticoid therapy for severe jaundice patients with drug-induced liver injury or hepatitis B virus-related acute-on-chronic liver failure: a respectively observational study.BMC infectious diseases · 2026Observational
- Novel Diagnostic Marker Interleukin-33 for Invasive Pulmonary Aspergillosis in Acute-on-Chronic Liver Failure: A Proof-of-Concept Prospective Study.Infectious diseases and therapy · 2026Article
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15 authors.
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Abstract
introductionThe incidence of Invasive pulmonary aspergillosis (IPA) in acute-on-chronic liver failure (ACLF) population is increasing, and its diagnosis and treatment is still a major clinical conundrum. This study aimed to characterize disease-stage-specific patterns and identify independent risk factors for IPA development in ACLF.
methodsA cohort of 835 ACLF patients (Jan 2014-Aug 2023) was retrospectively analyzed. IPA diagnosis followed Invasive Fungal Infections Group of the European Organization for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG). Comparative analysis included 55 ACLF-IPA cases versus 163 pulmonary infection controls without IPA. Multivariate logistic regression established risk factors, with predictive performance evaluated by ROC analysis.
resultsThe rate of clinical diagnosis of IPA in 835 ACLF patients was 6.6% (55/835). The median interval from ACLF diagnosis to IPA diagnosis was 31 days. The logistic regression model was C-Aged = 1.531 × [cirrhosis (yes:1, no:0)] + 1.511 × [diabetes mellitus (yes:1, no:0)] + 0.811 × [steroid exposure (yes:1, no:0)] + 0.033 × age + 1.520 × [types of broad-spectrum antibiotics ≥ 3 (yes:1, no:0)] -6.155. The derived predictive model demonstrated strong discrimination (AUROC = 0.828).
conclusionsIPA predominantly manifests in advanced ACLF stages (≥ 28 days). Critical risk factors include cirrhosis, diabetes, glucocorticoid use, advanced age, and multi-class antibiotic exposure. These findings enable risk-stratified surveillance and early intervention.
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