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

Objective To investigate the prognostic factors for patients with hepatitis B virus-related acute-on-chronic liver failure, and to provide a basis for clinical diagnosis and treatment.Methods A total of 172 patients with hepatitis B virus (HBV) -related acute-on-chronic liver failure who were admitted to The First Hospital of Jilin University from January 1, 2006 to January 1, 2016 and had complete medical records and follow-up data were enrolled, and a retrospective analysis was performed for their clinical data and laboratory markers to determine prognostic factors.The independent-samples t test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and a multivariate logistic regression analysis was performed for the indices determined to be statistically significant by the univariate analysis to screen out independent risk factors for the prognosis of patients with HBV-related acute-on-chronic liver failure.Results The multivariate logistic regression analysis was performed for the indices determined to be statistically significant by the univariate analysis, and the results showed that the prognostic factors were total bilirubin (TBil) , prothrombin time activity (PTA) , Na+, total cholesterol (TC) , Child-Turcotte-Pugh (CTP) score, age ≥50 years, the presence of liver cirrhosis, bilirubin-enzyme separation, and complications.The multivariate regression analysis was performed for the complications determined to affect prognosis by the univariate analysis, and the results showed that the complications as risk factors were hepatic encephalopathy, hepatorenal syndrome, and infection.Conclusion TBil, PTA, Na+, TC, CTP score, age ≥50 years, the presence of liver cirrhosis, bilirubin-enzyme separation, and complications are independent risk factors for the prognosis of patients with HBV-related acute-on-chronic liver failure.Liver failure patients with hepatic encephalopathy, hepatorenal syndrome, and infection tend to have poorer prognosis.Therefore, early judgment of the prognosis of patients with liver failure is of great importance in the prevention and treatment of related complications.