Characterizing a cohort of Egyptian patients with acute-on-chronic liver failure

Theodor Bilharz Research Institute

Bibliographic Information

Authors: El Ray A.; Fouad R.; Elmakhzangy H.; El Beshlawy M.; Moreau R.; Sherbiny M.

Journal: European Journal of Gastroenterology and Hepatology

Publisher: Lippincott Williams and Wilkins

Publication Date: 19 April 2021

Volume / Issue: Volume 33 / Issue 7

Pages: 1023–1028

ISSN: 0954691X

DOI: 10.1097/MEG.0000000000002165

Scopus: View on Scopus

PubMed: 33905215

Document Type: Article

Authors and Affiliations

El Ray A., Hepatogastroenterology Department, Theodor Bilharz Research Institute, El Nile St. Warak Elhadar P.Box 30, Giza, 12411, Egypt; Fouad R., Endemic Medicine and Hepatogastroenterolgy Department, Faculty of Medicine, Cairo University, Egypt; Elmakhzangy H., Endemic Medicine and Hepatogastroenterolgy Department, Faculty of Medicine, Cairo University, Egypt; El Beshlawy M., Endemic Medicine and Hepatogastroenterolgy Department, Faculty of Medicine, Cairo University, Egypt; Moreau R., EF Clif, EASL-CLIF Consortium and Grifols Chair, Barcelona, Spain, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Paris, Centre de Recherche sur l'Inflammation (CRI), Paris, France, Assistance Publique - Hôpitaux de Paris (APHP), Service d'Hépatologie & Réanimation HépatoDigestive, Hôpital Beaujon, Clichy, France; Sherbiny M., Hepatogastroenterology Department, Theodor Bilharz Research Institute, El Nile St. Warak Elhadar P.Box 30, Giza, 12411, Egypt

Abstract

Background and Aim Several studies performed in Western countries and Asia have shown that acute-on-chronic liver failure (ACLF) is an acute decompensation of cirrhosis characterized by organ system failures and high short-term mortality. However, the characteristics of Egyptian patients with ACLF have not yet been described. The aim of this study was to assess Egyptian patients with cirrhosis hospitalized for an acute decompensation using criteria and scores developed by the EASL-CLIF Consortium. Patients and methods One hundred and twenty patients with acutely decompensated cirrhosis nonelectively admitted to two tertiary hospitals were prospectively included. Ninety-three percent of patients had hepatitis C virus-related liver disease. Results Of the 120 patients, 40 had ACLF; of these 45% had ACLF-1, 33% ACLF-2, and the remaining 22% had ACLF-3. None of the patients with ACLF had received direct-antiviral agents (DAAs) while 30% of patients without ACLF were treated with these agents. The prevalence of prior episodes of decompensation was significantly higher in patients with ACLF (60% vs. 28%). The prevalence of precipitating events such as bacterial infection alone or combined with gastrointestinal hemorrhage was higher in patients with ACLF than in those without. Systemic inflammation, assessed with white blood-cell count and plasma C reactive levels, was more intense in ACLF. Conclusion Among Egyptian patients with acutely decompensated cirrhosis nonelectively admitted to the hospital, those with ACLF were distinct from those without ACLF, not only by the presence of organ failures, but also the absence DAA therapy, more frequent prior episodes of decompensation, more frequent bacterial infections as a precipitant, and more intense systemic inflammation. © 2021 Lippincott Williams and Wilkins. All rights reserved.

Keywords

acute-on-chronic liver failure; Egyptian patients; hepatitis C virus; Antiviral Agents; Egypt; Hepatitis C, Chronic; Humans; Liver Cirrhosis; Prognosis; alanine aminotransferase; albumin; antivirus agent; aspartate aminotransferase; bilirubin; creatinine; hypertensive factor; prothrombin; sodium ion; acute on chronic liver failure; adult; Article; bacterial infection; brain dysfunction; clinical assessment; cohort analysis; decompensated liver cirrhosis; Egyptian; female; gastrointestinal hemorrhage; hepatic encephalopathy; hospital admission; hospitalization; human; human tissue; ischemia; kidney failure; leukocyte count; liver failure; lung insufficiency; major clinical study; male; multicenter study; prevalence; prospective study; solitary kidney; tertiary care center; chronic hepatitis C; complication

Citation Information

Scopus Citations: 3

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