title: Association between plasma fibrinogen levels and mortality in acute-on-chronic hepatitis B liver failure.
abstract: Acute-on-chronic liver failure (AoCLF) is the most common type of liver failure and is associated with high mortality. Fibrinogen is critical in maintaining primary and secondary hemostasis. Therefore, we prospectively analyzed the association between fibrinogen and outcomes in AoCLF patients. Plasma fibrinogen was measured in 169 AoCLF, 173 chronic hepatitis B (CHB), and 171 healthy patients using a coagulation method. The predictive ability of fibrinogen for 3-month mortality in AoCLF patients was assessed using receiver operating characteristic (ROC) curve and multivariable logistic regression analyses. Plasma fibrinogen was significantly lower in nonsurvivor AoCLF patients compared with survivor AoCLF, CHB, and control patients. The sensitivity, specificity, and area under the ROC curve of 1/fibrinogen predicting mortality in AoCLF patients were 66.7%, 72.5%, and 0.746 (95% confidence interval (CI): 0.672-0.820, P < 0.001), and the fibrinogen cutoff value was 0.90 g/L. On multivariate logistic regression analysis, low fibrinogen was an independent factor predicting mortality (odds ratio: 0.304; 95% CI: 0.094-0.983; P = 0.047). Nonsurvivor AoCLF patients had significantly decreased fibrinogen levels, suggesting that low plasma fibrinogen may be a useful predictor of poor prognosis in AoCLF patients.
authors.affiliation: Department of Hospital Management Office, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, China ; Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, China.
authors.forename: Zhexin
authors.initials: Z
authors.lastname: Shao
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, China.
authors.forename: Limin
authors.initials: L
authors.lastname: Feng
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road No. 1, Hangzhou 310006, China.
authors.forename: Guofang
authors.initials: G
authors.lastname: Feng
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, China.
authors.forename: Juanwen
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000097:blood* / Q000209:etiology / Q000401:mortality; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006509:Hepatitis B / Q000097:blood* / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D005340:Fibrinogen