Prognostic value of dynamic changes in C-reactive protein to albumin ratio in patients with acute-on-chronic liver failure

Table 1 Baseline characteristics of patients stratified by 28-day survival status, n (%)

Characteristic	All patients (n = 126)	Survivors (n = 91)	Non-survivors (n = 35)	P value
Demographics
Age, years	51.8 ± 12.7	49.2 ± 13.0	54.2 ± 11.9	0.023
Male	95 (75.4)	69 (75.8)	26 (74.3)	0.682
Etiology of chronic liver disease				0.398
HBV infection	85 (67.5)	63 (69.2)	22 (62.9)
Alcohol	24 (19.0)	15 (16.5)	9 (25.7)
HCV infection	8 (6.3)	6 (6.6)	2 (5.7)
Autoimmune	6 (4.8)	5 (5.5)	1 (2.9)
Others	3 (2.4)	2 (2.2)	1 (2.9)
Precipitating events				0.176
HBV reactivation	49 (38.9)	35 (38.5)	14 (40.0)
Alcohol	32 (25.4)	22 (23.8)	10 (28.6)
Bacterial infection	23 (18.3)	16 (17.6)	7 (20.0)
Indeterminate	22 (17.5)	15 (16.5)	7 (20.0)
Complications
Ascites	82 (64.9)	52 (57.1)	30 (85.7)	0.002
Acute variceal bleeding	41 (32.5)	26 (28.6)	15 (42.9)	0.083
Hepatic encephalopathy	29 (23.0)	14 (15.4)	15 (42.9)	< 0.001
Grade 1-2	22 (17.5)	12 (13.2)	10 (28.6)	0.037
Grade 3-4	7 (5.6)	2 (2.2)	5 (14.3)	0.009
Organ failures
Liver	105 (83.7)	72 (79.1)	33 (94.3)	0.020
Coagulation	36 (28.6)	18 (19.8)	18 (51.4)	0.034
Circulation	22 (17.8)	9 (9.9)	13 (37.1)	0.027
Renal	13 (10.3)	5 (5.5)	8 (22.9)	0.004
Cerebral	7 (5.6)	2 (2.2)	5 (14.3)	0.008
Respiration	4 (3.4)	1 (1.1)	3 (8.6)	0.032
Laboratory parameters
Total bilirubin (mg/dL)	26.0 ± 9.0	22.1 ± 7.2	29.5 ± 9.3	< 0.001
Albumin (g/dL)	2.8 ± 0.5	3.0 ± 0.5	2.6 ± 0.4	0.023
ALT (U/L)	275 (139-657)	293 (157-678)	258 (124-642)	0.217
AST (U/L)	243 (149-528)	251 (158-541)	239 (137-516)	0.386
INR	2.26 ± 0.67	1.98 ± 0.47	2.51 ± 0.72	0.029
Creatinine (mg/dL)	1.41 ± 0.75	1.18 ± 0.53	1.62 ± 0.87	0.014
Sodium (mEq/L)	134.2 ± 5.8	135.9 ± 5.0	132.6 ± 6.1	0.006
Neutrophil count (109/L)	7.8 (5.2-11.8)	6.5 (4.6-9.2)	9.2 (6.7-13.5)	0.073
Lymphocyte count (109/L)	0.87 (0.58-1.31)	1.04 (0.72-1.47)	0.76 (0.52-1.12)	0.134
Platelet count (109/L)	79 (54-115)	86 (60-126)	73 (51-107)	0.213
Inflammatory indices
White blood cell count (109/L)	9.8 (6.9-14.2)	8.7 (6.3-11.8)	11.3 (8.2-16.1)	0.041
CRP (mg/L)	25.8 (14.6-42.9)	18.2 (11.4-29.5)	35.7 (22.1-51.9)	0.028
NLR	9.0 (8.8-9.2)	6.1 (4.1-9.4)	11.5 (7.8-17.2)	0.039
CAR	2.03 (1.52-3.27)	1.42 (0.95-2.31)	2.68 (1.82-4.23)	0.031
Prognostic scores
MELD	28.6 (23.9-33.4)	25.2 ± 5.5	31.8 ± 6.2	< 0.001
MELD-Na	30.7 (25.8-35.3)	27.6 ± 5.1	33.6 ± 5.8	< 0.001
CTP	11.3 ± 1.8	10.5 ± 1.6	12.0 ± 1.7	0.019
COSSH-ACLF	7.3 (6.1-8.7)	6.4 ± 1.2	8.2 ± 1.5	< 0.001
Mortality				< 0.001
ACLF 1 (n = 74)	10 (13.5)	64 (86.5)	10 (28.6)
ACLF 2 (n = 38)	15 (39.5)	23 (60.5)	15 (42.9)
ACLF 3 (n = 14)	10 (71.4)	4 (28.6)	10 (28.6)

Values are expressed as mean ± SD, median (interquartile range), or number (percentage). HBV: Hepatitis B virus; HCV: Hepatitis C virus; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; INR: International normalized ratio; CAR: C-reactive protein to albumin ratio; CRP: C-reactive protein; CTP: Child-Turcotte-Pugh; NLR: Neutrophil-to-lymphocyte ratio; MELD: Model for End-stage Liver Disease; COSSH-ACLF: Chinese Group on the Study of Severe Hepatitis B-Acute-on-Chronic Liver Failure; MELD-Na: Model for end-stage liver disease-sodium.