03 November 2020 : Original article
Comorbidity Burden May Be Associated with Increased Mortality in Patients with Severe Acute Liver Injury Referred for Liver Transplantation
Lindsey Steiner-Temnykh1ABCDEF, Lara Dakhoul2ABCDEF, James Slaven3ACDE, Lauren Nephew2BCDEF, Kavish R. Patidar2BCDEF, Eric Orman2BCDEF, Archita P. Desai2BCDEF, Eduardo Vilar-Gomez2BCDEF, Chandrashekhar Kubal4BCDEF, Burcin Ekser4BCDEF, Naga Chalasani2ABCDEF, Marwan Ghabril2ABCDEF*DOI: 10.12659/AOT.926453
Ann Transplant 2020; 25:e926453
Table 1 A comparison of demographic and clinical characteristics of patients surviving hospitalization vs. dying or undergoing liver transplantation within 30 days of hospitalization for acute liver injury. Data are shown as mean±standard deviation or number (percentage).
| All patientsN=136 | Hospitalization or 30-day survivorn=76 | Died or transplant within 30 daysn=60 | P-value | |
|---|---|---|---|---|
| Age | 37±13 | 34±13 | 40±14 | 0.02 |
| Gender (Female) n(%) | 106 (78) | 55 (72) | 51 (85) | 0.08 |
| Caucasian | 106 (78) | 62 (82) | 44 (73) | 0.4 |
| Black | 20 (15) | 9 (12) | 11 (18) | |
| Hispanic | 4 (3) | 2 (3) | 2 (3) | |
| Asian | 5 (4) | 2 (3) | 3 (5) | |
| Unknown | 1 (1) | 1 (1) | None | |
| Acetaminophen injury | 80 (58) | 57 (75) | 23 (38) | <0.001 |
| Autoimmune hepatitis | 10 (7) | 1 (1) | 9 (15) | |
| Drug-induced liver injury | 7 (5) | 2 (3) | 5 (8) | |
| Ischemic hepatitis | 10 (7) | 6 (8) | 4 (7) | |
| Viral | 8 (6) | 2 (3) | 6 (10) | |
| Undetermined | 13 (10) | 2 (3) | 11 (18) | |
| Other | 8 (6) | 6 (8) | 2 (3) | |
| Underlying liver disease n(%) | 18 (13) | 7 (9) | 11 (18) | 0.12 |
| Charlson Comorbidity Index | 1.1±1.8 | 0.8±1.2 | 1.5±2.4 | 0.03 |
| International normalized ratio | 4.3±3 | 3.3±1.7 | 5.7±3.7 | <0.001 |
| Bilirubin mg/dL | 7.2±7.8 | 4.5±5 | 10.8±9.3 | <0.001 |
| Creatinine mg/dL | 1.7±1 | 1.7±1.5 | 1.8±1.4 | 0.7 |
| Hepatic encephalopathy | 112 (82) | 54 (71) | 59 (98) | <0.001 |
| Jaundice | 94 (69) | 47 (62) | 47 (78) | 0.04 |
| Ascites | 40 (29) | 17 (22) | 23 (38) | 0.04 |
| Renal failure | 93 (68) | 46 (60) | 47 (78) | 0.03 |
| Received N-acetyl cysteine n (%) | 105 (77) | 67 (88) | 38 (63) | 0.001 |
| Received steroids n (%) | 15 (11) | 4 (5) | 11 (18) | 0.02 |
| Admitted to intensive care unit n (%) | 120 (90) | 62 (83) | 58 (98) | 0.003 |
| Mechanical ventilation n (%) | 83 (63) | 28 (38) | 55 (93) | <0.001 |
| Renal replacement therapy n (%) | 52 (42) | 17 (24) | 35 (66) | <0.001 |
| Vasopressors n(%) | 51 (58) | 15 (21) | 36 (71) | <0.001 |
| Model for End-stage Liver Disease | 30.7±9.9 | 26.8±9.1 | 36.3±8.2 | <0.001 |
| CLIF-SOFA | 10.8±4.2 | 9.2±3.8 | 12.8±3.9 | <0.001 |
| Met high risk Kings College Criteria n (%) | 38 (28) | 15 (20) | 23 (39) | 0.02 |
| Developed ALF at any time n (%) | 114 (84) | 55 (72) | 59 (98) | <0.001 |
| ALF – acute liver failure; CLIF-SOFA – Chronic Liver Failure Sequential Organ Failure Assessment | ||||