Association between blood ammonia and 90-day prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure

Tong JingJing; Mu XiuYing; Xu Xiang; Chen Jing; Zhai XingRan; Wang Yu; Su HaiBin; Liu XiaoYan; Hu JinHua

doi:10.3969/j.issn.1001-5256.2019.06.024

Volume 35 Issue 6

Jun. 2019

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Article Navigation > Journal of Clinical Hepatology > 2019 > 35(6): 1304-1307

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Association between blood ammonia and 90-day prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2019.06.024

Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital

Received Date: 2019-04-11
Published Date: 2019-06-20

Abstract

Abstract

Objective To investigate the association between baseline blood ammonia (BLA) and 90-day prognosis in patients with hepatitis B virus (HBV) -related acute-on-chronic liver failure (HBV-ACLF) . Methods A retrospective analysis was performed for the clinical data of 789 patients with HBV-ACLF who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January2013 to December 2016, and the association between baseline BLA and 90-day prognosis was analyzed. The Cox regression risk model was used for multivariate analysis. The Kaplan-Meier survival curve was used to analyze the 90-day survival rate of patients with different levels of baseline BLA, and the log-rank test was used for comparison. Results The Cox multivariate regression analysis showed that BLA was independently and positively correlated with the risk of 90-day death in HBV-ACLF patients (Model 2: hazard ratio = 1. 007, 95%confidence interval: 1. 005-1. 010, P < 0. 00001) . The log-rank test indicated that in the patients without hepatic encephalopathy (HE) , the BLAhigh group had the highest 90-day cumulative mortality rate, followed by the BLAmid group and the BLAlow group (P = 0. 0023) ; among the patients with HE, the BLAhigh group had a significantly higher 90-day cumulative mortality rate than the other two groups (P= 0. 012) , while there was no significant difference in 90-day cumulative mortality rate between these two groups (P = 0. 18) . Conclusion Baseline BLA is independently and positively correlated with the risk of 90-day death in HBV-ACLF patients, and it may have a certain clinical value in treatment and prognostic evaluation.
- blood ammonia,
- hepatitis B virus,
- acute-on-chronic liver failure,
- prognosis

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References

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Association between blood ammonia and 90-day prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2019.06.024