"Liver Failure at Admission or Afterward?" The Timing That Can Decide Life and Death [Health Check]

[Financial News] Among patients hospitalized for acute exacerbation of chronic liver disease, those who developed liver failure after admission had a death risk as high as 5.7 times that of patients with normal liver function. That was even higher than the 3.6-fold risk seen in patients who already had liver failure at the time of admission.
A study found that, in patients with acute exacerbation of chronic liver disease, prognosis is worse when organ failure develops after admission than when it is already present at the time of hospitalization.
A research team led by Professors Jang Young and Jang Jae-young of the Department of Gastroenterology at Soonchunhyang University Seoul Hospital analyzed how the order in which organ failure occurs affects short-term outcomes in 339 patients diagnosed with acute worsening of chronic liver disease at 31 university hospitals across South Korea from October 2015 to May 2019.
The study found that patients who already had liver failure at admission faced a higher risk of death than those without liver failure. The prognosis was even worse for patients who newly developed liver failure after admission. The death risk was 3.6 times higher for patients with liver failure at admission than for those without it, and it rose to 5.7 times when liver failure developed after hospitalization.
The timing also made a major difference in cases of kidney failure. Patients who already had kidney failure at admission showed no significant difference in survival rates compared with those without kidney failure, but those who newly developed kidney failure after admission tended to have lower survival rates. In particular, the 28-day survival rate for patients with kidney failure only at admission was 93.1%, above 90%.
Differences were also seen depending on the type of organ failure. Compared with patients who had only kidney failure at admission, the death risk was 2.42 times higher for those with only liver failure, and 2.53 times higher for those who developed both liver and kidney failure at the same time.
Professor Jang Young of the Department of Gastroenterology at Soonchunhyang University Seoul Hospital said, "This study confirmed that, in patients with acute exacerbation of chronic liver disease, it is important not only to look at how many organs are currently damaged, but also to identify which organ function declined first and how the condition then progressed to other organs."
Professor Jang Jae-young of the same department emphasized, "Because prognosis can deteriorate rapidly when new organ failure develops after admission, it is important to closely monitor the patient's condition from the early stages and provide treatment that prevents further organ damage."
Meanwhile, the paper by Professors Jang Young and Jang Jae-young, titled "The Order of Liver Failure and Organ Failure and Prognosis in Acute-on-Chronic Liver Failure," was published in the international gastroenterology journal Gut and Liver in April.
 


[email protected] Jung Myung-jin, medical reporter Reporter