Guo Hebing, Yin Ningning, Liu Jingyuan, Li Ang
Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing, 100015, China.
BMC Gastroenterol. 2025 Sep 3;25(1):637. doi: 10.1186/s12876-025-04234-x.
Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) pose significant threats to patient outcomes, frequently resulting in multiple organ dysfunction syndrome (MODS) and elevated mortality rates. This study investigates MODS outcomes among ALF and ACLF patients in China, identifying key factors that influence mortality and prognosis.
A retrospective cohort analysis was conducted at a specialized tertiary hospital in Beijing, covering the period from June 2009 to May 2022, which included 585 patients:195 with ALF and 390 with ACLF.
Among these, 61% of ALF patients and 45.1% of ACLF patients developed MODS. ALF patients exhibited a higher incidence of organ failures and significantly higher median admission critical illness scores. Multivariate logistic regression analysis identified age, number of organ failures, and platelet count as independent predictors of 90-day mortality. Kaplan-Meier survival hazards analysis revealed significantly higher 90-day cumulative mortality rates for ALF patients compared to ACLF patients (33.8% vs. 25.9%, p = 0.009).
Approximately 50% of liver failure patients progress to MODS, with ALF patients demonstrating a higher incidence of MODS and poorer 90-day prognoses.
急性肝衰竭（ALF）和慢加急性肝衰竭（ACLF）对患者预后构成重大威胁，常导致多器官功能障碍综合征（MODS）并使死亡率升高。本研究调查了中国ALF和ACLF患者的MODS转归情况，确定了影响死亡率和预后的关键因素。
在北京一家三级专科医院进行了一项回顾性队列分析，涵盖2009年6月至2022年5月期间的585例患者：195例ALF患者和390例ACLF患者。
其中，61%的ALF患者和45.1%的ACLF患者发生了MODS。ALF患者的器官衰竭发生率更高，入院时的中位危重病评分显著更高。多因素逻辑回归分析确定年龄、器官衰竭数量和血小板计数为90天死亡率的独立预测因素。Kaplan-Meier生存风险分析显示，ALF患者的90天累积死亡率显著高于ACLF患者（33.8%对25.9%，p = 0.009）。
约50%的肝衰竭患者进展为MODS，ALF患者的MODS发生率更高，90天预后更差。
