Role of ammonia in predicting the outcome of patients with acute-on-chronic liver failure

doi:10.12998/wjcc.v9.i3.552

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Jan 26, 2021 (publication date) through May 4, 2024

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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. Jan 26, 2021; 9(3): 552-564
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.552

Table 5 Comparison of patient characteristics based on the presence of high venous ammonia

Variable	Venous ammonia > 152.5 μmol/L, n (%) 99 (23.1)	Venous ammonia ≤ 152.5 μmol/L, n (%) 329 (76.9)	P value
Age, median (IQR)	57 (48-65)	60 (50-65)	0.481
Male sex, n (%)	58 (58.6)	190 (57.8)	0.883
Albumin (g/dL), mean ± SD	2.33 ± 0.54	2.38 ± 0.59	0.452
Bilirubin (mg/dL), median (IQR)	2.7 (1.48-5)	2.33 (1.37-4.7)	0.230
INR, median (IQR)	1.5 (1.31-1.83)	1.46 (1.27-1.72)	0.584
Creatinine (mg/dL), median (IQR)	0.85 (0.63-1.54)	0.81 (0.63-1.18)	0.397
Platelets (× 10⁹/L), median (IQR)	121 (73-173)	134 (93-182)	0.134
WBC (× 10⁹/L), median (IQR)	8.39 (5.251-11.02)	7.26 (5.47-9.92)	0.359
CRP (mg/dL), median (IQR)	1.4 (0.84-4.16)	1.5 (0.8-2.98)	0.682
HE, n (%)	265 (80.5)	96 (97)	< 0.001
HE grade III or IV, n (%)	55 (20.8)	49 (51)	< 0.001
Sodium (mmol/L), median (IQR)	134 (131-137)	134 (129-137)	0.970
Child-Pugh score, median (IQR)	11 (10-12)	11 (10-12)	0.173
Child-Pugh class, n (%)
A	1 (1)	2 (0.6)
B	12 (12.4)	70 (21.4)
C	84 (86.6)	255 (78)
MELD, mean ± SD	20.76 ± 7.72	18.61 ± 6.34	0.013
AARC score, median (IQR)	7 (6-8)	9 (9-11)	< 0.001
ACLF, n (%)
Grade I	47 (47.5)	238 (72.3)
Grade II	46 (46.5)	87 (26.4)
Grade III	6 (6.1)	4 (1.2)
Ascites, n (%)	82 (82.8)	308 (93.6)	0.001
Upper GI bleeding, n (%)	22 (22.4)	57 (17.3)	0.252
SBP, n (%)	4 (4)	20 (6.1)	0.440
Other infections, n (%)	16 (16.2)	49 (14.9)	0.758
AKI, n (%)	16 (16.2)	32 (9.7)	0.075
HCC, n (%)	5 (5.1)	6 (1.8)	0.137
Hospital stay (d), median (IQR)	8 (6-11)	5 (3-10)	0.969
In-hospital death rate, n (%)	24 (24.2)	10 (3)	< 0.001

IQR: Interquartile range; SD: Standard deviation; INR: International normalized ratio; WBC: White blood cells; CRP: C-reactive protein; MELD: Model for end-stage liver disease; AARC score: APASL ACLF Research Consortium score; HE: Hepatic encephalopathy; GI: Gastrointestinal; AKI: Acute kidney injury; SBP: Spontaneous bacterial peritonitis; HCC: Hepatocelular carcinoma.

Citation: Chiriac S, Stanciu C, Cojocariu C, Singeap AM, Sfarti C, Cuciureanu T, Girleanu I, Igna RA, Trifan A. Role of ammonia in predicting the outcome of patients with acute-on-chronic liver failure. World J Clin Cases 2021; 9(3): 552-564
URL: https://www.wjgnet.com/2307-8960/full/v9/i3/552.htm
DOI: https://dx.doi.org/10.12998/wjcc.v9.i3.552