Fig 1.
Flowchart of the study group selection process.
Abbreviations: ACLF, acute-on-chronic liver failure; APASL, Asia–Pacific Association for the Study of the Liver; CMA, Chinese Medical Association; EASL-CLIF, EASL-Chronic Liver Failure.
Table 1.
Characteristics of eligible patients at enrollment.
Fig 2.
Comparison of survival among patients with ACLF at enrollment defined by different criteria.
Overall 394 eligible patients who qualified for at least APASL criteria for ACLF at enrollment were divided into 3 groups: patients satisfying APASL criteria alone for ACLF at enrollment (group A), patients satisfying both APASL and CMA criteria but not EASL-CLIF criteria for ACLF at enrollment (group B), and patients satisfying EASL-CLIF criteria in addition to APASL criteria for ACLF at enrollment (group C). In comparison with patients in group A and group B, the 90-day survival was significantly lower for patients in group C (log-rank test: P < 0.001). Besides, significantly lower survival was also observed for patients in group B, as compared to patients in group A (log-rank test: P < 0.05).
Fig 3.
Comparison of survival between patients with and without progression to post-enrollment EASL-CLIF ACLF.
Patients with ACLF at enrollment defined by APASL criteria alone were classified into group A, while patients with ACLF at enrollment defined by both APASL and CMA criteria but not EASL-CLIF criteria were classified into group B. Among the entire 276 patients in groups A and B, patients with progression to post-enrollment EASL-CLIF ACLF had a significantly lower survival than those without (log-rank test: P < 0.001) (A). Among patients in either group A (B) or group B (C), significantly lower survival was also observed in patients with progression to post-enrollment EASL-CLIF ACLF than those without (log-rank test: P < 0.001). Abbreviations: ACLF, acute-on-chronic liver failure; EASL-CLIF, EASL-Chronic Liver Failure.
Fig 4.
Mortality rate at 90 days according to the grade of ACLF defined by EASL-CLIF Consortium.
Among patients identified as EASL-CLIF ACLF either at enrollment or after enrollment, the 90-day mortality rate was 39.1% for grade 1, 54.1% for grade 2, 86.7% for grade 3, respectively. The 90-day mortality rate in patients without EASL-CLIF ACLF both at enrollment and after enrollment was 2.1%. Abbreviations: ACLF, acute-on-chronic liver failure.
Table 2.
Comparison of baseline characteristics between patients with and without progression to post-enrollment EASL-CLIF ACLF.
Table 3.
Comparison of characteristics after enrollment between patients with and without progression to post-enrollment EASL-CLIF ACLF.
Table 4.
Multivariate Cox regression analysis of independent predictors associated with progression into post-enrollment EASL-CLIF ACLF from ACLF at enrollment defined by APASL alone or by both APASL and CMA but not by EASL-CLIF Consortium.