ANALYSIS OF CASES OF ACUTE ON CHRONIC LIVER FAILURE IN PATIENTS WITH CIRRHOSIS IN 2023-2024
Abstract
Background. Acute-on-chronic liver failure (ACLF) is a severe form of acute decompensation of liver cirrhosis associated with high mortality. Objective. To assess the incidence, severity, precipitating factors and outcomes of ACLF in patients with cerebral palsy admitted to the inpatient department of the city hospital. Material and methods. The study included 283 patients during 347 episodes of hospitalization to the gastroenterology and intensive care units of the 2nd Minsk City Clinical Hospital in 2023-2024. Results. ACLF was diagnosed during 111 episodes of hospitalization, accounting for 53.6% (95% CI 46,8-60,4) of acute decompensation (n=207) and 32.0% (95% CI 27,1-36,9) of all hospitalization episodes (n=347) in patients with cirrhosis. ACLF-1 was noted in 35 of 111 patients, including ACLF-1a in 10, ACLF-1b in 25, ACLF-2 in 29 and ACLF-3 in 47. Of the 111 patients with ACLF, 61 died (55,0%), including 35 (57,4%) without a history of liver cirrhosis: 7 of 35 (20%) died with ACLF-1, 13 of 29 (45%) with ACLF-2, 41 of 47 (87%) with ACLF-3, including 16 of 22 with ACLF 3a, and all 25 with ACLF-3b. Of the number of deceased patients (n=61), bacterial infections were established in 53 (87%). Conclusion. Analysis of ACLF cases allows us to demonstrate the importance of understanding the meaning, content and mechanisms of ACLF as well as the challenging task it poses on healthcare institutions in managing patients with this complex pathology and high risk of adverse outcome.
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