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001-es BibID:	BIBFORM088130
035-os BibID:	(WoS)000640696100013 (Scopus)85101877901
Első szerző:	Trebica, Jonel
Cím:	PREDICT identifies Precipitating Events Associated with Clinical Course of Acutely Decompensated Cirrhosis / Jonel Trebicka, Javier Fernandez, Maria Papp, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Ushcner, Christian Jansen, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Peter Jarcuska, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, Debbie Shawcross, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Karen V. Danielsen, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Jose Presa Ramos, Cristina Sole, German Soriano, Andrea de Gottardi, Henning Groenbaek Faouzi, Saliba Trautwein, Christian Haluk, Tarik Kani, Sven Francque, Stephen Ryder, Pierre Nahon, Manuel Romero Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Michael Praktiknjo, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, William Bernal, Ferran Aquilar, Joan Claria, Paolo Ponzo, Zsuzsanna Vitalis, Giacomo Zaccherini, Boglarka Balogh, Alexander Gerbes, Victor Vargas, Carlo Alessandria, Mauro Bernardi, Pere Gines, Richard Moreau, Paolo Angeli, Rajiv Jalan, Vicente Arroyo
Dátum:	2021
ISSN:	0168-8278
Megjegyzések:	ABSTRACT Introduction: Acute decompensation (AD) of cirrhosis may present without acute-onchronic liver failure (ACLF) (AD-No ACLF), or with ACLF-phenotype (AD-ACLF) defined by organ failure(s). Precipitating events may induce AD. This multicenter,prospective, observational PREDICT Study (NCT03056612) analyzes and characterizes the precipitants leading to both AD-phenotypes. Patients and Methods: The PREDICT study included 1273 non-electively hospitalized patients with AD (No-ACLF=1071; ACLF=202). Medical history, clinical and laboratory data were carefully collected at enrolment and during 90-days follow up, focused on the characteristics of precipitants, specifically induction of organ dysfunction/failure and/or systemic inflammation, chronology, intensity, and relationship to outcome in both AD phenotypes. Results: Among different clinical events, four distinct events were precipitants consistently related to AD, including proven bacterial infections, severe alcoholic hepatitis, gastrointestinal (GI) bleeding with shock and toxic encephalopathy. Among patients in the AD-No ACLF cohort and the AD-ACLF cohort with precipitants (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Interestingly, in both AD-phenotypes, proven bacterial infections and severe alcoholic hepatitis had a similar association withsurvival, and the number of precipitants was associated with significantly increased 90-day mortality, in paralleled by surrogates of systemic inflammation confirming a valid definition of precipitating events. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with lower ACLF development rate and higher 90-day survival. Conclusions: This study identified precipitating events that are significantly associated with a distinct clinical course and prognosis of patients with AD and specific preventive and therapeutic strategies targeting these events may improve outcome in decompensated cirrhosis.
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. - 74 : 5 (2021), p. 1097-1108. -
További szerzők:	Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jansen, Christian Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Jarcuska, Peter Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Shawcross, Debbie Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Danielsen, Karen V. Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Ramos, José Sole, Cristina Soriano, German Gottardi, Andrea De Faouzi, Henning Groenbaek Trautwein, Saliba Haluk, Christian Kani, Tarik Francque, Sven Ryder, Stephen Nahon, Pierre Gomez, Manuel Romero Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Praktiknjo, Michael Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Bernal, William Aquilar, Ferran Claria, Joan Ponzo, Paolo Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Gerbes, Alexander Vargas, Victor Alessandria, Carlo Bernardi, Mauro Ginès, Pere Moreau, Richard Angeli, Paolo Jalan, Rajiv Arroyo, Vicente
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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