Investigation on the short-term outcome and prognostic impact of predisposition,and precipitants in inpatients with chronic liver disease from Chinese AcuTe on CHronic LIver FailurE(CATCH-LIFE)cohorts  

作　　者：Yan Zhang Wenting Tan Xiaobo Wang Xin Zheng Yan Huang Beiling Li Zhongji Meng Yanhang Gao Zhiping Qian Feng Liu Xiaobo Lu Jia Shang Yubao Zheng Weituo Zhang Shan Yin Wenyi Gu Tongyu Wang Jianyi Wei Zixuan Shen Guohong Deng Yi Zhou Yixin Hou Qun Zhang Shue Xiong Jing Liu Liyuan Long Ruochan Chen Jinjun Chen Xiuhua Jiang Sen Luo Yuanyuan Chen Chang Jiang Jinming Zhao Liujuan Ji Xue Mei Jing Li Tao Li Rongjiong Zheng Xinyi Zhou Haotang Ren Yu Shi Hai Li for the CATCH‐LIFE Study Investigators of Chinese(Acute‐on)Chronic Liver Failure(CLIF)Consortium(Ch‐CLIFC) 

机构地区：[1]Department of Gastroenterology,Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai,China [2]Shanghai Institute of Digestive Disease,NHC Key Laboratory of Digestive Diseases,Shanghai,China [3]Department of Infectious Diseases,Southwest Hospital,Third Military Medical University(Army Medical University),Chongqing,China [4]Center of Integrative Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing,China [5]Department of Infectious Diseases,Institute of Infection and Immunology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,China [6]Hunan Key Laboratory of Viral Hepatitis,Department of Infectious Diseases,Xiangya Hospital,Central South University,Changsha,Hunan,China [7]Department of Infectious Diseases,Hepatology Unit,Nanfang Hospital,Southern Medical University,Guangzhou,Guangdong,China [8]Department of Infectious Disease,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei,China [9]Department of Hepatology,The First Hospital of Jilin University,Jilin,Changchun,China [10]Department of Liver Intensive Care Unit,Shanghai Public Health Clinical Centre,Fudan University,Shanghai,China [11]Tianjin Institute of Hepatology,Nankai University Second People's Hospital,Tianjin,China [12]Department of Infectious Diseases and Hepatology,The Second Hospital of Shandong University,Jinan,Shandong,China [13]Infectious Disease Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,China [14]Department of Infectious Diseases,Henan Provincial People's Hospital,Zhengzhou,Henan,China [15]Deparment of Infectious Diseases,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou City,Guangdong,China [16]Clinical Research Center,Shanghai Jiao Tong University School of Medicine,Shanghai,China [17]The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital of School of Medicine,Zhejiang University,Hangzhou,Zhejiang,China [18]Collaborative Innovation Center for Diagnosis a

出　　处：《Portal Hypertension & Cirrhosis》2023年第3期115-126,共12页门静脉高压与肝硬化（英文）

基　　金：Clinical Research Plan of SHDC,Grant/Award Number:SHDC2020CR1037B;Shanghai Municipal Key Clinic Specialty,Grant/Award Number:shslczdzk00602;National Key R&D Program of China,Grant/Award Number:2017YFC0908100;National Science and Technology Major Project,Grant/Award Numbers:2018ZX10302206,2018ZX10723203,2017ZX10202202;Shanghai Municipal Education Commission–Guofeng Clinical Medicine Grant Support,Grant/Award Number:20152213;National Natural Science Foundation of China,Grant/Award Numbers:82170629,81930061,81900579,81970550,82070613,82070650,81972265,81870425,81774234;Shanghai Hospital Development Commission,Grant/Award Number:16CR1024B;Chongqing Natural Science Foundation,Grant/Award Number:CSTC2019jcyjzdxmX0004;Beijing Municipal Science&Technology Commission,Grant/Award Number:Z191100006619033;Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program,Grant/Award Number:2017BT01S131;Clinical Research Program of Nanfang Hospital,Southern Medical University,Grant/Award Numbers:2018CR037,2020CR026;Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education,Grant/Award Number:LC2019ZD006;President Foundation of Nanfang Hospital,Southern Medical University,Grant/Award Number:2019Z003;Foundation for Innovative Research Groups of Hubei Provincial Natural Science Foundation,Grant/Award Number:2018CFA031;Hubei Province's Outstanding Medical Academic Leader Program and Project of Hubei University of Medicine,Grant/Award Numbers:FDFR201902,2020XGFYZR05;Fundamental Research Funds for the Central Universities,Grant/Award Number:2021FZZX001-41;Guangdong Basic and Applied Basic Research Foundation,Grant/Award Number:2020A1515010052;Natural Fund of Guangdong Province,Grant/Award Number:2016A030313237;Guangzhou City Science and Technology Project,Grant/Award Number:201607010064。

摘　　要：Aim:The study aimed to investigate the short-term outcomes of hospitalized patients with chronic liver disease(CLDs)and assess the prognostic impact of predisposition and precipitants,which currently remains unclear.Methods:The study included 3970 hospitalized patients with CLDs from two prospective longitudinal multicenter studies(NCT02457637 and NCT03641872)conducted in highly endemic hepatitis B virus(HBV)areas.Competing risk analysis was used to evaluate the effect of predispositions,including the etiology and severity of CLDs and precipitants;on sequential 28,90,and 365-day liver transplantation(LT)-free mortality.Results:Among all enrolled patients,76.8%of adverse outcomes(including death and LT)within one year occurred within 90 days.Compared with alcoholic etiology,the association of HBV etiology with poorer outcomes was remarkably on the 28th day(hazard ratio[HR],1.81;95%confidence interval[CI],1.07-3.06;p=0.026);however,and dimin-ished or became insignificant at 90 days and 365 days.Cirrhosis increased the adjusted risk for 365-day(HR,1.50;CI,1.13-1.99;p=0.004)LT-free mortality when compared with noncirrhosis.In patients with cirrhosis,prior decompensation(PD)independently increased the adjusted risk of 365-day LT-free mortality by 1.25-fold(p=0.021);however,it did not increase the risk for 90-day mortality.Neither the category nor the number of precipitants influenced the adjusted risk of 28 or 90-day LT-free mortality.Conclusions:The 90-day outcome should be considered a significant endpoint for evaluating the short-term prognosis of hospitalized patients with CLD.Predisposing factors,other than etiology,mainly affected the delayed(365-day)outcome.Timely effective therapy for CLD etiology,especially antiviral treatments for HBV,and post-discharge long-term surveillance monitoring in cirrhotic patients undergoing PD are suggested to enhance disease management and reduce mortality.

关 键 词：cirrhosis PRECIPITANT prior decompensation short‐term mortality 

分 类 号：R575.2[医药卫生—消化系统]