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1.
001-es BibID:
BIBFORM086407
035-os BibID:
(WoS)000572079900019 (Scopus)85088972261
Első szerző:
Trebica, Jonel
Cím:
The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology / Jonel Trebicka, Javier Fernandez, Papp Mária, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Uschner, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Martin Janicko, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, William Bernal, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Lise Lotte Gluud, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Ana Cristino, Cristina Sole, Germán Soriano, Andrea de Gottardi, Henning Groenbaek, Faouzi Saliba, Christian Trautwein, Osman Cavit Özdogan, Francque Sven, Stephen Ryder, Pierre Nahon, Manuel Romero-Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, Debbie Showcross, Ferran Aguilar, Joan Claria, Paolo Ponzo, Christian Jansen, Vitális Zsuzsanna, Giacomo Zaccherini, Balogh Boglárka, Victor Vargas, Sara Montagnese, Carlo Alessandria, Mauro Bernardi, Pere Gines, Rajiv Jalan, Richard Moreau, Paolo Angeli, Vicente Arroyo
Dátum:
2020
ISSN:
0168-8278
Megjegyzések:
Background/Aims:Acute decompensation (AD) of cirrhosis is defined by the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, i nfection or any combination of these, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF), while their absence defines AD. We designed the PREDICT study, a European, prospective, observational study, to characterize the clinical course of AD and predict ACLF . Methods:A total of 1071 patients with AD were enrolled to collect detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed-up for 3 months. The 12-month outcomes (liver transplantation, and death) were also recorded. Results:Three groups of patients were identified: Pre-ACLF patients (n=218), who developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ?1 readmission but not developing ACLF and had 21.0% and 35.6% mortality rates. Stable decompensated cirrhosis (SDC) patients (n = 620) who were neither readmitted, nor developed ACLF and showed a 1-year mortality of only 9.5%. The 3 groups differed significantly in the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in the SDC) and prevalence of surrogates of severe portal hypertension throughout the study (high in UDC versus low in pre-ACLF and SDC). Conclusions:Acute decompensation without ACLF is a heterogeneous condition with three different clinical courses and two major pathophysiological mechanisms: systemic inflammation and portal hypertension. Prediction of ACLF development remains a major future task.(ClinicalTrials.gov number, NCT03056612)
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Chronic liver disease
non-elective admission
acute complications
Outcome
Risk factors
Megjelenés:
Journal of Hepatology. - 73 (2020), p. 842-854. -
További szerzők:
Fernández, Javier
Papp Mária (1975-) (belgyógyász, gasztroenterológus)
Caraceni, Paolo
Laleman, Wim
Gambino, Carmine
Giovo, Ilaria
Uschner, Frank Erhard
Jimenez, Cesar
Mookerjee, Rajeshwar
Gustot, Thierry
Albillos, Agustin
Bañares, Rafael
Janicko, Martin
Steib, Christian
Reiberger, Thomas
Acevedo, Juan
Gatti, Pietro
Bernal, William
Zeuzem, Stefan
Zipprich, Alexander
Piano, Salvatore
Berg, Thomas
Bruns, Tony
Gluud, Lise Lotte
Coenraad, Minneke
Merli, Manuela
Stauber Rudolf
Zoller, Heinz
Cristino, Ana
Sole, Cristina
Soriano, German
Gottardi, Andrea De
Groenbaek, Henning
Saliba, Faouzi
Trautwein, Christian
Özdogan, Osman Cavit
Sven, Francque
Ryder, Stephen
Nahon, Pierre
Romero-Gomez, Manuel
Vlierberghe, Hans Van
Francoz, Claire
Manns, Michael P.
Garcia, Elisabet
Tufoni, Manuel
Amoros, Alex
Pavesi, Marco
Sánchez, Cristina
Curto, Anna
Pitarch, Carla
Putignano, Antonella
Moreno, Esau
Showcross, Debbie
Aguilar, Ferran
Claria, Joan
Ponzo, Paolo
Jansen, Christian
Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus)
Zaccherini, Giacomo
Balogh Boglárka (1993-) (belgyógyász)
Vargas, Victor
Montagnese, Sara
Alessandria, Carlo
Bernardi, Mauro
Ginès, Pere
Jalan, Rajiv
Moreau, Richard
Angeli, Paolo
Arroyo, Vicente
Internet cím:
DOI
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