Patients hospitalized with acute deterioration of chronic liver disease face a significantly worse prognosis if they develop new organ failure after admission, with both the timing and type of organ failure affecting outcomes, a study has found.
Study Scope and Methodology
Soon Chun Hyang University Hospital Seoul announced Monday that a research team led by Professors Chang Young and Jang Jae-young of the Department of Gastroenterology analyzed how the sequence of organ failure affects short-term outcomes in patients with acute-on-chronic liver failure. The study involved 339 patients diagnosed with acute deterioration of chronic liver disease at 31 university hospitals across Korea between October 2015 and May 2019.
Researchers examined survival outcomes based on which organs failed and when those failures occurred during hospitalization. The findings were published in Gut and Liver in April.
Timing of Liver Failure Matters
Patients who had liver failure at admission showed a 3.6-fold higher risk of death compared to those without liver failure. Those who developed liver failure after hospitalization faced an even steeper risk, with mortality 5.7 times higher than patients without liver failure.
Related: Cataract Surgery Leads Korea, C‑Sections Surge
The type of organ affected also played a role in determining outcomes. Patients with liver failure alone at admission had a 2.42-fold higher risk of death than those with kidney failure alone, while patients with both liver and kidney failure showed a 2.53-fold higher mortality risk.
Kidney Failure Shows Different Pattern
Kidney failure behaved differently depending on when it appeared. Patients who already had kidney failure at admission showed no significant difference in survival compared with those without kidney failure, while those who developed kidney failure after admission tended to have lower survival rates.
Notably, patients who had kidney failure alone at admission had a 28-day survival rate of 93.1 percent, suggesting that isolated kidney involvement carries a different prognosis than liver involvement in this patient population.
If new organ failures develop after hospitalization, the condition can deteriorate rapidly, which means early and continuous monitoring becomes especially important for patients admitted with acute-on-chronic liver failure.
Related: EuBiologics Invests $10M, Raises US Vaccine JV Stake
Clinical Implications
Professor Chang Young said the findings indicate clinicians should look beyond simply counting impaired organs. “The findings show that it is important not only to look at how many organs are currently impaired, but also to identify which organ first begins to deteriorate and how the dysfunction subsequently progresses to other organs,” he said.
Professor Jang Jae-young emphasized the need for close monitoring from an early stage. “Because the prognosis can deteriorate rapidly when new organ failure develops after hospitalization, patients should be closely monitored from an early stage, and treatment aimed at preventing additional organ damage is key,” he said.
The researchers noted that understanding the sequence of organ failure could help clinicians anticipate complications and intervene before additional organs become involved.