Acute-on-chronic liver failure data from a teaching hospital in Brazil. A Historical Cohort.

Rafael Maciel Grochot; Lais Bender Luz; Rafael Garcia; Raul Angelo Balbinot; Silvana Sartori Balbinot; Jonathan Soldera

Volume : IX, Issue : V, May - 2020

Acute-on-chronic liver failure data from a teaching hospital in Brazil. A Historical Cohort.

Rafael Maciel Grochot, Lais Bender Luz, Rafael Garcia, Raul Angelo Balbinot, Silvana Sartori Balbinot, Jonathan Soldera

Abstract :

BACKGROUND: Patients with organ failures associated with cirrhosis may have a higher risk of death in the short term. It has been suggested that a particular clinical entity, acute–on–chronic liver failure (ACLF), could be responsible for this increase in mortality. DESIGN AND SETTING: Historical cohort study conducted in a mixed public and private tertiary care teaching hospital. METHODS: Data from hospital charts from January 2013 to December 2014 were obtained by searching the hospital electronic database for codes of liver disease. Paper medical charts were hand–analyzed. Liver–specific scores were calculated and Cox regression was used to access the association of the variables with survival, through univariate and multivariate analysis. RESULTS: In the final analysis, 51 patients were included. Of these, 18 had ACLF (7 grade 1, 10 grade 2 and 1 grade 3). In a multivariate analysis, female sex, higher Chronic Liver Failure Sequential Organ Failure Assessment (CLIF–SOFA) score, presence of ACLF, hepatocellular carcinoma and HIV were associated with a higher 30–, 90– and 365–day mortality. CONCLUSION: The presence of ACLF was able to predict adverse outcomes in a cohort of a mixed public and private teaching hospital in Brazil.