Prognostic risk factors in patients with hepatitis B virus- related acute- on- chronic liver failure

Objective To investigate the clinical characteristic and long- term prognosis risk factor of patients with hepatitis B virus- related acute- on- chronic liver failure( HBV- ACLF). Methods The clinical data of 1116 HBV- ACLF patients who were hospitalized in Southwest Hospital of Third Military Medical University from January 2010 to January 2015 were analyzed retrospectively. The risk factors for1- year survival time and prognosis were observed,and the Cox regression model was used to determine the independent risk factors for the prognosis of these patients. The t- test or t'- test was applied for comparison of continuous data between groups,and the chi- square test was applied for comparison of categorical data between groups. Results A total of 562 patients died within the 1- year follow- up period,and the fatality rate was 50. 4%. The comparison between the survival group and the death group showed that age,alanine aminotransferase,total bilirubin,urea nitrogen,serum creatinine,international normalized ratio,serum Na+,white blood cell( WBC),percentage of neutrophils,platelet( PLT),HBV DNA load,Model for End- Stage Liver Disease( MELD) score,ascites,spontaneous bacterial peritonitis,gastrointestinal bleeding,pulmonary infection,sepsis,electrolyte disturbance,hepatic encephalopathy,and acute kidney injury( AKI)were the risk factors for death within 1 year( all P < 0. 05). The Cox regression analysis showed that age,WBC,MELD score,hepatic encephalopathy,electrolyte disturbance,AKI,and PLT were the independent risk factors for the 1- year fatality in HBV- ACLF patients( all P < 0. 05). Conclusion Our findings show that HBV- ACLF has a high fatality rate and is often accompanied by serious complications.The major risk factors affecting the 1- year fatality in HBV- ACLF patients are age,WBC,MELD score,hepatic encephalopathy,electrolyte disturbance,AKI,and PLT.