Clinical characteristics and 28-d outcomes of bacterial infections in patients with hepatitis B virus-related acute-on-chronic liver failure

doi:10.12998/wjcc.v8.i6.1042

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World Journal of Clinical Cases

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Mar 26, 2020; 8(6): 1042-1055
Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1042

Table 5 Independent predictors of 28-d outcomes in hepatitis B virus-related acute-on-chronic liver failure patients combined with bacterial infections

Variable	Survivors (n = 58)	Nonsurvivors (n = 99)	Univariate Cox regression		Multivariate Cox regression
Variable	Survivors (n = 58)	Nonsurvivors (n = 99)	HR (95%CI)	P value	HR (95%CI)	P value
Age (yr)	45.5 ± 9.7	49.3 ± 10.7	1.023 (1.005-1.042)	0.013
Male (%)	53 (91.4)	82 (82.8)	0.693 (0.410-1.170)	0.170
Cirrhosis (%)	50 (86.2)	85 (85.9)	0.956 (0.543-1.684)	0.877
SIRS (%)	17 (29.3)	58 (58.6)	2.214 (1.480-3.310)	< 0.001
Temperature (°C)	37.1 (36.6, 38.0)	37.1 (36.6, 38.0)	1.055 (0.861-1.293)	0.604
MAP (mmHg)	86.9 ± 11.4	88.9 ± 15.5	1.003 (0.987-1.019)	0.696
Invasive catheterization (%)	6 (10.3)	26 (26.3)	2.026 (1.290-3.181)	0.002	2.173 (1.320-3.579)	0.002
Grade of ACLF
ACLF-1 (%)	44 (75.9)	35 (35.4)	Reference	< 0.001
ACLF-2 (%)	12 (20.7)	29 (29.3)	1.977 (1.205-3.243)	0.007
ACLF-3 (%)	2 (3.4)	35 (35.4)	4.648 (2.862-7.548)	< 0.001
HBV DNA (log10 IU/ml)	3.6 (2.3, 5.5)	4.7 (2.8, 6.6)	1.083 (0.997-1.177)	0.060
WBC (×10⁹/L)	7.5 (5.6, 11.3)	10.4 (6.9, 15.0)	1.054 (1.022-1.088)	0.001
NEUT (×10⁹/L)	5.4 (3.4, 8.6)	8.5 (5.1, 12.7)	1.058 (1.023-1.094)	0.001
HGB (g/L)	105.0 ± 21.6	109.3 ± 26.3	1.003 (0.994-1.011)	0.516
PLT (×10⁹/L)	64.0 (46.8, 88.5)	63.0 (40.0, 98.0)	1.000 (0.995-1.005)	0.984
ALB (g/L)	28.0 (25.0, 31.0)	28.0 (23.0, 31.0)	0.984 (0.945-1.024)	0.435
TBIL (μmol/L)	353.6 ± 130.9	356.4 ± 163.7	1.000 (0.999-1.001)	0.836
DBIL (μmol/L)	257.4 ± 88.3	236.8 ± 113.7	0.998 (0.996-1.000)	0.091
ALT (IU/L)	76.5 (35.3, 127.8)	103.0 (49.0, 352.0)	1.001 (1.000-1.001)	0.003
AST (IU/L)	118.0 (71.0, 165.0)	136.0 (85.0, 367.0)	1.001 (1.000-1.001)	< 0.001
ALP (IU/L)	158.5 (125.8, 211.3)	137.0 (99.0, 179.0)	1.000 (0.998-1.001)	0.721
GGT (IU/L)	49.0 (35.8, 78.8)	56.0 (33.0, 78.0)	0.999 (0.995-1.004)	0.821
Cr (μmol/L)	98.5 (79.5, 126.3)	122.0 (87.0, 196.0)	1.002 (1.001-1.003)	0.001
Na (mmol/L)	133.0 (130.0, 136.0)	132.0 (128.0, 136.0)	0.996 (0.962-1.031)	0.830
INR	1.9 (1.7, 2.3)	2.6 (2.1, 3.3)	1.762 (1.487-2.089)	< 0.001
PTA (%)	33.2 ± 11.1	23.3 ± 9.9	0.937 (0.917-0.957)	< 0.001	0.967 (0.941-0.993)	0.015
CRP (mg/L)	20.5 (13.2, 43.4)	16.2 (8.9, 39.6)	0.998 (0.991-1.005)	0.530
PCT (ng/mL)	1.2 (0.8, 1.8)	1.2 (0.6, 2.9)	1.017 (1.002-1.033)	0.025
Ascites (%)	57 (98.3)	96 (97.0)	0.578 (0.183-1.828)	0.351
AKI (%)	24 (41.4)	61 (61.6)	2.777 (1.734-4.449)	< 0.001	2.187 (1.259-3.799)	0.005
HE (%)	23 (39.7)	76 (76.8)	1.635 (1.089-2.454)	0.018
AVB (%)	8 (13.8)	26 (26.3)	1.476 (0.942-2.312)	0.089
Pneumonia (%)	20 (34.5)	59 (59.6)	1.831 (1.222-2.744)	0.003
SBP (%)	34 (58.6)	33 (33.3)	0.553 (0.364-0.842)	0.006
BSI (%)	6 (10.3)	20 (20.2)	1.661 (1.016-2.715)	0.043	2.339 (1.384-3.952)	0.002
Other BIs (%)	4 (6.9)	16 (16.2)	1.488 (0.870-2.544)	0.146
Multiple sites of BIs (%)	6 (10.3)	24 (24.2)	1.797 (1.132-2.852)	0.013
MDROs (%)	4 (6.9)	11 (11.1)	1.401 (0.728-2.696)	0.313
CA BIs (%)	4 (6.9)	13 (13.1)	1.537 (0.857-2.757)	0.149
HCA BIs (%)	24 (41.4)	47 (47.5)	1.046 (0.705-1.553)	0.821
Nosocomial BIs (%)	30 (51.7)	39 (39.4)	0.804 (0.537-1.204)	0.290
COSSH-ACLF Scores	6.1 (5.8, 6.7)	7.4 (6.6, 8.7)	1.704 (1.498, 1.937)	< 0.001	1.371 (1.127-1.666)	0.002

SIRS: Systemic inflammation response syndrome; MAP: Mean arterial pressure; ACLF: Acute-on-chronic liver failure; HBV: Hepatitis B virus; WBC: White blood cells; NEUT: Neutrophil count; HGB: Hemoglobin; PLT: Platelet; ALB: Albumin; TBIL: Total bilirubin; DBIL: Direct bilirubin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; Cr: Creatinine; Na: Sodium; INR: International normalized ratio; PTA: Prothrombin activity; CRP: C-reactive protein; PCT: Procalcitonin; AKI: Acute kidney injury; HE: Hepatic encephalopathy; AVB: Acute variceal bleed; SBP: Spontaneous bacterial peritonitis; BSI: Bloodstream infection; BIs: Bacterial infections; MDROs: Multidrug-resistant organisms; CA: Community-acquired; HCA: Healthcare-associated; COSSH: Chinese Group on the Study of Severe Hepatitis B.

Citation: Li C, Su HB, Liu XY, Hu JH. Clinical characteristics and 28-d outcomes of bacterial infections in patients with hepatitis B virus-related acute-on-chronic liver failure. World J Clin Cases 2020; 8(6): 1042-1055
URL: https://www.wjgnet.com/2307-8960/full/v8/i6/1042.htm
DOI: https://dx.doi.org/10.12998/wjcc.v8.i6.1042