title: Predictors of the outcomes of acute-on-chronic hepatitis B liver failure.
abstract: OBJECTIVE
  To identify the risk factors in predicting the outcome of acute-on-chronic hepatitis B liver failure patients.
  
  
  METHODS
  We retrospectively divided 113 patients with acute-on-chronic liver failure-hepatitis B virus (ACLF-HBV) and without concurrent hepatitis C or D virus infection and hepatocellular carcinoma into two groups according to their outcomes after anti-HBV therapy. Their demographic, clinical, and biochemical data on the day of diagnosis and after the first week of treatment were analyzed using the Mann-Whitney U test, Fisher's exact test, and a multiple logistic regression analysis.
  
  
  RESULTS
  The study included 113 patients (87 men and 26 women) with a mean age of 49.84 years. Fifty-two patients survived, and 61 patients died. Liver failure (85.2%), sepsis (34.4%), and multiple organ failure (39.3%) were the main causes of death. Multivariate analyses showed that Acute Physiology and Chronic Health Evaluation (APACHE) II scores ≥ 12 [odds ratio (OR) = 7.160, 95% CI: 2.834-18.092, P < 0.001] and positive blood culture (OR = 13.520, 95% CI: 2.740-66.721, P = 0.001) on the day of diagnosis and model for end-stage liver disease (MELD) scores ≥ 28 (OR = 8.182, 95% CI: 1.884-35.527, P = 0.005) after the first week of treatment were independent predictors of mortality.
  
  
  CONCLUSIONS
  APACHE II scores on the day of diagnosis and MELD scores after the first week of anti-HBV therapy are feasible predictors of outcome in ACLF-HBV patients.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, China.
authors.forename: Hsiu-Lung
authors.initials: HL
authors.lastname: Fan
authors.forename: Po-Sheng
authors.initials: PS
authors.lastname: Yang
authors.forename: Hui-Wei
authors.initials: HW
authors.lastname: Chen
authors.forename: Teng-Wei
authors.initials: TW
authors.lastname: Chen
authors.forename: De-Chuan
authors.initials: DC
authors.lastname: Chan
authors.forename: Chi-Hong
authors.initials: CH
authors.lastname: Chu
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Kuo
authors.forename: Chung-Bao
authors.initials: CB
authors.lastname: Hsieh
mesh_terms: D018806:APACHE; D000328:Adult; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index