Clinical Profile of Patients Admitted with Acute on Chronic Liver Failure (T0163)

Introduction: Acute on chronic liver failure (ACLF) is a life-threatening condition characterized by the rapid deterioration of liver function in patients with underlying chronic liver disease. It is associated with high morbidity and mortality due to the complex interplay of liver dysfunction and multi-organ failure. Identifying the clinical profile of these patients is essential for effective management and improving outcomes.

Aims and Objectives:

Aim:

The aim of this study is to investigate various aspects related to acute-on-chronic liver failure (ACLF), including the clinical profile of patients, the underlying chronic etiology, acute precipitating factors, and the mortality rates at both 30 days.

Objective:

1. To analyze and document the clinical characteristics and manifestations exhibited by patients diagnosed with acute-on-chronic liver failure.
2. To identify and examine the chronic etiologies underlying the development of acute-on-chronic liver failure, as well as to assess the acute precipitating factors contributing to its onset.

Methods: A retrospective analysis was conducted on patients admitted with ACLF over a period of one year at a tertiary care center. Data on demographic characteristics, etiology of chronic liver disease, precipitating factors for acute decompensation, clinical manifestations, and laboratory results were collected. The outcomes, including mortality, response to treatment, and need for liver transplantation, were also recorded.

Results: The study included 100 patients, with the majority suffering from alcohol-related liver disease and viral hepatitis. Common precipitating factors included infections and gastrointestinal bleeding. Clinical manifestations were dominated by jaundice, ascites, hepatic encephalopathy, and renal dysfunction. The overall mortality rate was 40%, with liver transplantation required in 15% of cases.

Conclusion: Patients with ACLF present with a complex clinical profile involving multi-organ dysfunction. Timely identification of precipitating factors and early intervention are critical for improving survival. Strategies to prevent acute decompensation are essential in managing these high-risk patients.

Keywords: Acute on chronic liver failure, Clinical profile, Liver transplantation, Precipitating factors, Mortality, Hepatic encephalopathy.