Background and Aims: The patients with acute on chronic organ failure (ACLF) have both hepatic and extrahepatic insults. The number of organ failures and grades of ACLF determine outcome of the patient. We aimed to study the outcome in ACLF patient with different organ failures in this single center study.
Methods: A total of 52 ACLF patients with different numbers of organ failures at time of admission (9patients with one, 17 with two, 11 with three, 8 with four and 7 with five organ failures) were taken. The outcome during hospital stay and survival at 90 days were analyzed.
Results: Majority of patients (82.6 %) were male. Alcohol consumption was most common cause of cirrhosis; present in 32 (61.5%) patients. 28 (53.8%)patients had continued alcohol consumption as an acute precipitating event. None of the 15 patients with 4 and 5 organ failures survived during hospital stay whereas hospital survival was highest in patients with one (6/9; 66.6%) followed by patients with three (4/11; 36.3%) and two (6/17; 35.2%) organ failures. 90 days survival analysis showed only 7 (13.5%) patients surviving. The mortality rates were higher in ACLF grade 3 (92.3%) as compared to ACLF grade 2 (76.4%) and ACLF grade 1 (55.5%).
Conclusion: In ACLF, the outcome is determined by the number of organ failures and different grades of ACLF subsequently. Mere analysis of liver function test in ACLF patients can lead to erroneous decisions in management and poor outcome.
Impact Factor
2022: 6.012
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