Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. rs641738C>T near MBOAT7 is associated with liver fat, ALT and fibrosis in NAFLD: A meta-analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Rebleeding and mortality risk are increased by ACLF but reduced by pre-emptive TIPS

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Standardisation of diet and exercise in clinical trials of NAFLD-NASH: Recommendations from the Liver Forum

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  1. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Fibrogenesis and inflammation contribute to the pathogenesis of cirrhotic cardiomyopathy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Cholesteryl ester storage disease of clinical and genetic characterisation: A case report and review of literature

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. An update on cirrhotic cardiomyopathy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • PREDICT STUDY group of the EASL-CLIF CONSORTIUM
Vis graf over relationer

INTRODUCTION: Acute decompensation (AD) of cirrhosis may present without acute-on-chronic liver failure (ACLF) (AD-No ACLF), or with ACLF phenotype (AD-ACLF) defined by organ failure(s). Precipitants may induce AD. This multicenter, prospective, observational PREDICT study (NCT03056612) analyzes and characterizes the precipitants leading to both of these AD phenotypes.

PATIENTS AND METHODS: The PREDICT study included 1273 non-electively hospitalized patients with AD (No-ACLF=1071; ACLF=202). Medical history, clinical and laboratory data were collected at enrolment and during 90-day follow up, with particular attention to the following characteristics of precipitants: induction of organ dysfunction or failure, systemic inflammation, chronology, intensity, and relationship to outcome.

RESULTS: Among various clinical events, four distinct events were precipitants consistently related to AD, including proven bacterial infections, severe alcoholic hepatitis, gastrointestinal (GI) bleeding with shock and toxic encephalopathy. Among patients with precipitants in the AD-No ACLF cohort and the AD-ACLF cohort (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. In both AD phenotypes, patients with proven bacterial infections or severe alcoholic hepatitis had a similar survival. The number of precipitants was associated with significantly increased 90-day mortality, and was paralleled by increasing levels of surrogates for systemic inflammation. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with lower ACLF development rate and lower 90-day mortality.

CONCLUSIONS: This study identified precipitants that are significantly associated with a distinct clinical course and prognosis of patients with AD and specific preventive and therapeutic strategies targeting these events may improve outcome in decompensated cirrhosis.

OriginalsprogEngelsk
TidsskriftJournal of Hepatology
ISSN0168-8278
DOI
StatusE-pub ahead of print - 20 nov. 2020

Bibliografisk note

Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

ID: 61307619