BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus(HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation(HD) and acute-...BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus(HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation(HD) and acute-on-chronic liver failure(ACLF) in patients with severe acute exacerbation(SAE) of chronic HBV infection remain unknown.AIM To identify risk factors related to progression to HD and ACLF in compensated patients with SAE of chronic HBV infection.METHODS The baseline characteristics of 164 patients with SAE of chronic HBV infection were retrospectively reviewed. Independent risk factors associated with progression to HD and ACLF were identified. The predictive values of our previously established prediction model in patients with acute exacerbation(AE model) and the model for end-stage liver disease(MELD) score in predicting the development of ACLF were evaluated.RESULTS Among 164 patients with SAE, 83(50.6%) had compensated liver cirrhosis(LC),43 had progression to HD without ACLF, and 29 had progression to ACLF within 28 d after admission. Independent risk factors associated with progression to HD were LC and low alanine aminotransferase. Independent risk factors for progression to ACLF were LC, high MELD score, high aspartate aminotransferase(AST) levels, and low prothrombin activity(PTA). The area under the receiver operating characteristic of the AE model [0.844, 95%confidence interval(CI): 0.779-0.896] was significantly higher than that of MELD score(0.690, 95%CI: 0.613-0.760, P < 0.05) in predicting the development of ACLF.CONCLUSION In patients with SAE of chronic HBV infection, LC is an independent risk factor for progression to both HD and ACLF. High MELD score, high AST, and low PTA are associated with progression to ACLF. The AE model is a better predictor of ACLF development in patients with SAE than MELD score.展开更多
Objective To investigate the prognostic value of cardiactroponin I in acute decompensated heart failure( ADHF ) patients with preserved ejection fraction.Methods We included 326 consecutive ADHF patientswith preserved...Objective To investigate the prognostic value of cardiactroponin I in acute decompensated heart failure( ADHF ) patients with preserved ejection fraction.Methods We included 326 consecutive ADHF patientswith preserved ejection fraction from January 2016 to January2017. Patients were divided into two groups basedon cardiac troponin I levels. Group A included patientswith elevated troponin I level (cTnI≥0. 04 ng /ml) andgroup B included patients with normal troponin I level(cTnI < 0. 04 ng /ml). BNP levels,length of hospitalstay,readmission rate,30-day and 180-day all-causemortality were compared between the two groups. Results(1) There were 185 patients ( 56. 7%) in thegroup A and 141 patients in the group B. (2) Male ratio(44. 9% vs 32. 6%,P < 0. 05),serum creatinine levelsat admission ([120. 6 ± 48. 2]μmmol /L vs [107. 4 ±51. 2]μmmol /L,P < 0. 05),BNP levels([846 ± 575]pg /ml vs [423 ± 387] pg /ml,P < 0. 05),30-day and180-day all-cause mortality (5. 4% vs 0. 7%,9. 2% vs2. 8%,P < 0. 05) were all significantly higher in groupA than in group B.展开更多
基金Supported by the National Natural Science Foundation of China,No.81460124 and No.81860114
文摘BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus(HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation(HD) and acute-on-chronic liver failure(ACLF) in patients with severe acute exacerbation(SAE) of chronic HBV infection remain unknown.AIM To identify risk factors related to progression to HD and ACLF in compensated patients with SAE of chronic HBV infection.METHODS The baseline characteristics of 164 patients with SAE of chronic HBV infection were retrospectively reviewed. Independent risk factors associated with progression to HD and ACLF were identified. The predictive values of our previously established prediction model in patients with acute exacerbation(AE model) and the model for end-stage liver disease(MELD) score in predicting the development of ACLF were evaluated.RESULTS Among 164 patients with SAE, 83(50.6%) had compensated liver cirrhosis(LC),43 had progression to HD without ACLF, and 29 had progression to ACLF within 28 d after admission. Independent risk factors associated with progression to HD were LC and low alanine aminotransferase. Independent risk factors for progression to ACLF were LC, high MELD score, high aspartate aminotransferase(AST) levels, and low prothrombin activity(PTA). The area under the receiver operating characteristic of the AE model [0.844, 95%confidence interval(CI): 0.779-0.896] was significantly higher than that of MELD score(0.690, 95%CI: 0.613-0.760, P < 0.05) in predicting the development of ACLF.CONCLUSION In patients with SAE of chronic HBV infection, LC is an independent risk factor for progression to both HD and ACLF. High MELD score, high AST, and low PTA are associated with progression to ACLF. The AE model is a better predictor of ACLF development in patients with SAE than MELD score.
文摘Objective To investigate the prognostic value of cardiactroponin I in acute decompensated heart failure( ADHF ) patients with preserved ejection fraction.Methods We included 326 consecutive ADHF patientswith preserved ejection fraction from January 2016 to January2017. Patients were divided into two groups basedon cardiac troponin I levels. Group A included patientswith elevated troponin I level (cTnI≥0. 04 ng /ml) andgroup B included patients with normal troponin I level(cTnI < 0. 04 ng /ml). BNP levels,length of hospitalstay,readmission rate,30-day and 180-day all-causemortality were compared between the two groups. Results(1) There were 185 patients ( 56. 7%) in thegroup A and 141 patients in the group B. (2) Male ratio(44. 9% vs 32. 6%,P < 0. 05),serum creatinine levelsat admission ([120. 6 ± 48. 2]μmmol /L vs [107. 4 ±51. 2]μmmol /L,P < 0. 05),BNP levels([846 ± 575]pg /ml vs [423 ± 387] pg /ml,P < 0. 05),30-day and180-day all-cause mortality (5. 4% vs 0. 7%,9. 2% vs2. 8%,P < 0. 05) were all significantly higher in groupA than in group B.
