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Table 1 Characteristics of ACLF patients with or without LDCA

From: Association between longer duration of citrate accumulation and 90-day mortality of acute-on-chronic liver failure

  Patients with LDCA (N = 76) Patients without LDCA (N = 182) p
Female 25 (32.9%) 12 (6.6%) < 0.001
Age(years) 52.2 ± 10.9 43.8 ± 11.2 < 0.001
Liver cirrhosis 61 (80.3%) 141 (77.5%) 0.620
Causes of liver disease    0.963
 HBV infection only 57 (75.0%) 137 (75.3%)  
 HBV infection plus other causes 19 (25.0%) 45 (24.7%)  
Comorbidities    0.112
 No 59 (77.6%) 156 (85.7%)  
 Yes 17 (22.4%) 26 (14.3%)  
Disease severity assessment    
 COSSHACLF score 7.1 ± 1.0 6.3 ± 0.8 < 0.001
 CLIF-C ACLF score 38.9 ± 6.9 32.7 ± 6.5 < 0.001
 AARCACLF score 10.7 ± 1.6 9.6 ± 1.5 < 0.001
 MELD score 29.8 ± 5.5 25.7 ± 3.9 < 0.001
Laboratory examination
PT-INR 2.36 (1.95–2.81) 2.06 (1.75–2.44) 0.009
Serum creatinine (× ULN) 0.97 (0.80–1.32) 0.80 (0.65–0.88) < 0.001
Total bilirubin (μmol/L) 431.0 ± 135.4 421.9 ± 120.0 0.495
 Direct bilirubin to total bilirubin ratio 0.75 (0.70–0.82) 0.80 (0.73–0.86) 0.009
 Alanine aminotransferase (IU/L) 140 (56–300) 124 (66–245) 0.891
 Aspartate aminotransferase (IU/L) 139 (76–227) 116 (88–192) 0.133
 Aspartate aminotransferase to alanine aminotransferase ratio 1.13 (0.65–1.92) 1.06 (0.64–1.53) 0.495
 Albumin (g/L) 31.8 ± 3.6 31.8 ± 4.0 0.742
 Albumin to globulin ratio 1.2 ± 0.4 1.2 ± 0.4 0.041
 Ammonia (mmol/L) 77.6 (58.0–117.8) 79.1 (60.9–110.2) 0.891
 Lactate (mmol/L) 2.98 (2.03–3.89) 2.40 (1.90–3.00) < 0.001
 Serum sodium (mmol/L) 130.7 ± 15.8 134.5 ± 4.1 0.009
 Serum potassium (mmol/L) 3.44 ± 0.55 3.46 ± 0.58 0.866
 Serum chloride (mmol/L) 93.9 ± 5.6 97.3 ± 4.4 < 0.001
 Hemoglobin (g/L) 111 ± 18 122 ± 20 0.002
 Platelets (× 109/L) 83 (48–114) 91 (64–124) 0.180
 White blood cells (× 109/L) 7.87 ± 4.08 7.47 ± 3.48 0.495
Intracorporeal Catot before PA therapy (mmol/L) 2.16 ± 0.15 2.13 ± 0.13 0.133
Intracorporeal Caion before PA therapy (mmol/L) 1.020 ± 0.089 1.051 ± 0.076 0.123
Intracorporeal Catot during PA therapy (mmol/L) 2.06 ± 0.21 1.97 ± 0.24 0.595
Intracorporeal Caion during PA therapy (mmol/L) 0.749 ± 0.098 0.808 ± 0.109 0.262
Extracorporeal Caion during PA therapy (mmol/L) 0.167 (0.132–0.233) 0.184 (0.145–0.238) 0.345
Intracorporeal Catot 2 h after PE therapy (mmol/L) 2.65 ± 0.26 2.46 ± 0.18 < 0.001
Intracorporeal Caion 2 h after PE therapy (mmol/L) 0.962 ± 0.100 1.103 ± 0.081 < 0.001
Catot/Caion 2 h after PE therapy 2.70 (2.58–2.90) 2.22 (2.14–2.32) < 0.001
Anion gap 2 h after PE therapy (mmol/L) 7.67 ± 2.90 6.85 ± 2.34 0.010
DPMAS plus PE therapy with RCA
 Sessions 3.0 (2.3–5.0) 4.0 (3.0–6.0) 0.204
 Days from the first to the last sessions 7.0 (4.0–14.0) 8.0 (5.0–14.0) 0.292
90-day prognosis (death) 48 (63.2%) 59 (32.4%) < 0.001
  1. Quantitative data are represented as mean ± SD (normally distributed data) or median (interquartile range) (non-normally distributed data) and compared by Mood's median test. Qualitative data are represented as frequencies (proportion) and compared by Chi-squared test
  2. ACLF, Acute-on-chronic liver failure; LDCA, longer duration of citrate accumulation; HBV, hepatitis B virus; COSSH, Chinese Group on the Study of Severe Hepatitis B; CLIF-C, European Association for the Study of the Liver—Chronic Liver Failure-Consortium; AARC, APASL ACLF Research Consortium; APASL, Asian Pacific Association for the Study of the Liver; MELD, Model for End-Stage Liver Disease; PT-INR, international normalized ratio (INR) of prothrombin time (PT); ULN, upper limit of normal; PA, plasma adsorption; PE, plasma exchange; Catot, total calcium; Caion, ionized calcium; Catot/Caion, Catot to Caion ratio