Acute-on-chronic liver failure in a multi-ethnic Asian city: A comparison of patients identified by Asia-Pacific Association for the Study of the Liver and European Association for the Study of the Liver definitions

Table 4 Demographics, type of organ failure and laboratory parameters of acute-on-chronic liver failure patients with respect to outcome n (%)

	Deaths (n = 45)	Survivors (n = 33)	P value
Age (mean-range)	60 (56-64)	55 (52-58)	0.0441
Liver transplantation	0	11 (34.4)	< 0.00012
Race
Chinese	33 (73.3)	21 (63.6)	0.0041
Malay	6 (13.3)	2 (6.1)
Indian	6 (13.3)	2 (6.1)
Others	0	8 (24.2)
Male gender	33 (73.3)	26 (78.8)	0.5791
Diabetes mellitus	13 (28.9)	15 (45.5)	0.1321
Previous hepatic decompensation	16 (37.2)	18 (56.2)	0.1011
Potential events leading to acute insult
Infection	28 (62.2)	18 (54.5)	0.4961
Hepatitis B flare	15 (33.3)	8 (24.2)	0.3841
Variceal bleeding	10 (22.2)	9 (27.3)	0.6081
Unknown cause	5 (11.1)	6 (18.2)	0.2872
Alcohol	2 (4.4)	4 (12.1)	0.2042
TCM	5 (11.1)	1 (3)	0.1892
TIPSS	1 (2.2)	0	0.5772
Underlying chronic liver disease
Hepatitis B	20 (44.4)	14 (42.4)	0.8591
Alcohol	10 (22.2)	6 (18.2)	0.6621
Cryptogenic	4 (8.9)	5 (15.2)	0.3072
Hepatitis C	3 (6.7)	2 (6.1)	0.6462
NASH	2 (4.4)	2 (6.1)	0.5672
Hepatitis B + alcohol	1 (2.2)	1 (3)	0.6702
Others1	6 (13.3)	3 (9.1)	0.4192
Liver cirrhosis	41 (91)	29 (87.9)	0.4592
HCC+ (Milan criteria)	3 (6.7)	2 (6.1)	0.7092
Other cancers2	2 (4.4)	3 (9.1)
None	40 (88.9)	28 (84.8)
Organ failures-clif-sofa score
Liver	31 (68.9)	17 (51.5)	0.1191
Kidney	31 (68.9)	10 (30.3)	0.0011
Cerebral	17 (37.8)	4 (12.1)	0.0121
Coagulation	31 (68.9)	19 (57.6)	0.3031
Circulation	28 (63.6)	7 (21.2)	< 0.00011
Respiration	8 (17.8)	1 (3)	0.0442
Chronic renal disease	9 (20)	2 (6.1)	0.0752
Leucocyte count at baseline (mean-range)	11 (10-12)	10 (8-12)	0.2733
Platelet count at baseline (mean-range)	135 (109-160)	120 (79-160)	0.5283
Amylase (mean-range)	117 (90-144)	72 (38-105)	0.0263
Maximal total bilirubin (mean-range)	20.2 (16.3-24)	15.9 (11.5-20.2)	0.1373
Maximal creatinine (mean-range)	2.9 (2.4-3.3)	1.6 (1.3-1.9)	< 0.00013
Maximal INR (mean-range)	4.3 (3.5-5.1)	3 (2.5-3.6)	0.0183
MELD at baseline (mean-range)	26 (23-29)	22 (19-25)	0.1193
Lactate at baseline (mean-range)	3.5 (2.4-4.6)	2.8 (2-3.7)	0.3113

¹χ² test;

²Fisher exact test;

³Independent t-test. TCM: Traditional Chinese Medicine; TIPSS: Transjugular intrahepatic portosystemic shunt; NASH: Non-alcoholic steatohepatitis; HCC: Hepatocellular carcinoma; APASL: Asia-Pacific Association for the Study of the Liver; EASL: European Association for the Study of the Liver.