title: [Clinical characteristics of patients with acute-on-chronic liver failure and splenomegaly].
abstract: OBJECTIVE
  To observe the clinical characteristics and short-term survival of patients with splenomegaly and acute-on-chronic liver failure related to chronic HBV infection.
  
  
  METHODS
  Electronic medical records of patients with acute-on-chronic liver failure were collected to analyze the clinical parameters and 4-week survival of patients with or without splenomegaly.
  
  
  RESULTS
  Of the 149 patients enrolled, the overall 28-day mortality rate was 48.3%, which was lower in patients with enlarged spleen than those without (34.2% vs 54.1%, P=0.034). Compared with patients without splenomegaly, patients with splenomegaly had lower platelet counts (P=0.001), lower ALT levels (P=0.005) and lower PT-INR (P=0.010). Although the occurrence of hepatic encephalopathy was comparable between patients with or without splenomegaly, severe conditions were more frequent in those without splenomegaly. Hepatic encephalopathy grades, serum creatinine levels, neutrophil percentages over 70%, PT-INR and splenomegaly were independent factors associated with the 28-day survival, and this novel model was superior to model of end-stage of liver disease in predicting the 4-week survival (P=0.017).
  
  
  CONCLUSIONS
  Patients with splenomegaly that evolves into acute-on-chronic liver failure have unique clinical characteristics and further clinical observations are warranted.
authors.affiliation: Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail: zhmingxia@hotmail.com.
authors.forename: Mingxia
authors.initials: M
authors.lastname: Zhang
authors.forename: Guoqi
authors.initials: G
authors.lastname: Qin
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Qinjun
authors.initials: Q
authors.lastname: He
authors.forename: Yajing
authors.initials: Y
authors.lastname: He
authors.forename: Wenfan
authors.initials: W
authors.lastname: Luo
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Jinjun
authors.initials: J
authors.lastname: Chen
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000401:mortality / Q000503:physiopathology*; D002908:Chronic Disease; D006501:Hepatic Encephalopathy / Q000503:physiopathology; D006801:Humans; D013163:Splenomegaly / Q000401:mortality / Q000503:physiopathology*