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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Jongbeom Shin (Inha University) Jung Hwan Yu (Inha University) Young-Joo Jin (Inha University) Hyung Joon Yim (Korea University) Young Kul Jung (Korea University) Jin Mo Yang (The Catholic University of Korea) Do Seon Song (The Catholic University of Korea) Young Seok Kim (Soonchunhyang University) Sang Gyune Kim (Soonchunhyang University) 김동준 (Hallym University) 석기태 (한림대학교) Eileen L. Yoon (Inje University) Sang Soo Lee (Gyeongsang National University) Chang-Wook Kim (The Catholic University of Korea) Hee Yeon Kim (The Catholic University of Korea) Jae Young Jang (Soonchunhyang University) Soung Won Jeong (Soonchunhyang University) Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group (Korean Acute-on-Chronic Liver Failure (KACLiF) Study Group)
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제26권 제4호
발행연도
2020.1
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540 - 553 (14page)

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Background/Aims: This study examined the risk factors associated with mortality in cirrhotic patients hospitalized with variceal bleeding, and evaluated the effects of acute-on-chronic liver failure (ACLF) on the prognosis of these patients. Methods: This study was retrospectively conducted on patients registered in the Korean acute-on-chronic liver failure study cohort, and on 474 consecutive cirrhotic patients hospitalized with variceal bleeding from January 2013 to December 2013 at 21 university hospitals. ACLF was defined as described by the European Association for the Study of Liver-Chronic Liver Failure Consortium. Results: Among a total of 474 patients, 61 patients were diagnosed with ACLF. The cumulative overall survival (OS) rate was lower in the patients with ACLF than in those without (P<0.001), and patients with higher ACLF grades had a lower OS rate (P<0.001). The chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score was identified as a significant prognostic factor in patients hospitalized with variceal bleeding (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.30?1.50; P<0.001), even in ACLF patients with variceal bleeding (HR, 1.32; 95% CI, 1.19?1.46, P<0.001). Concerning the prediction of the mortality risk at 28- and 90-day using CLIF-SOFA scores, c-statistics were 0.895 (95% CI, 0.829?0.962) and 0.897 (95% CI, 0.842?0.951), respectively, and the optimal cut-off values were 6.5 and 6.5, respectively. Conclusions: In cirrhotic patients hospitalized with variceal bleeding, the prognosis was poor when accompanied by ACLF, especially depending upon CLIF-SOFA score. CLIF-SOFA model well predicted the 28-day or 90-day mortality for cirrhotic patients who experienced variceal bleeding.
#Acute-on-chronic liver failure #Variceal bleeding #Prognosis #Sequential organ failure assessment

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참고문헌 (37)

참고문헌 신청
Graham DY / 1981 / The course of patients after variceal hemorrhage / Gastroenterology 80:800~809 google schola D’Amico G / 1999 / Pharmacological treatment of portal hypertension : an evidence-based approach / Semin Liver Dis 19:475~505 google schola 김영대 / 2014 / Management of Acute Variceal Bleeding / Clinical Endoscopy 47(4):308~314 dbpia Villanueva C / 2006 / A randomized controlled trial comparing ligation and sclerotherapy as emergency endoscopic treatment added to somatostatin in acute variceal bleeding / J Hepatol 45:560~567 google schola Krige JE / 2006 / Variceal recurrence, rebleeding, and survival after endoscopic injection sclerotherapy in 287 alcoholic cirrhotic patients with bleeding esophageal varices / Ann Surg 244:764~770 google schola

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