Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study
Background/Aims Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD bas...
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Taylor & Francis Group
2025-12-01
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2024.2428431 |
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| author | Jung Hee Kim Sung-Eun Kim Do Seon Song Hee Yeon Kim Eileen L. Yoon Ji Won Park Tae Hyung Kim Young-Kul Jung Ki Tae Suk Hyung Joon Yim Jung Hyun Kwon Sung Won Lee Seong Hee Kang Moon Young Kim Soung Won Jeong Jae-Young Jang Jeong Ju Yoo Sang Gyune Kim Young-Joo Jin Gab Jin Cheon Byung Seok Kim Yeon Seok Seo Hyoungsu Kim Dong Hyun Sinn Woo Jin Chung Hwi Young Kim Han Ah Lee Seung Woo Nam In Hee Kim Ji Hoon Kim Hee Bok Chae Joo Hyun Sohn Ju Yeon Cho Yoon Jun Kim Jin Mo Yang Jung Gil Park Won Kim Hyun Chin Cho Dong Joon Kim |
| author_facet | Jung Hee Kim Sung-Eun Kim Do Seon Song Hee Yeon Kim Eileen L. Yoon Ji Won Park Tae Hyung Kim Young-Kul Jung Ki Tae Suk Hyung Joon Yim Jung Hyun Kwon Sung Won Lee Seong Hee Kang Moon Young Kim Soung Won Jeong Jae-Young Jang Jeong Ju Yoo Sang Gyune Kim Young-Joo Jin Gab Jin Cheon Byung Seok Kim Yeon Seok Seo Hyoungsu Kim Dong Hyun Sinn Woo Jin Chung Hwi Young Kim Han Ah Lee Seung Woo Nam In Hee Kim Ji Hoon Kim Hee Bok Chae Joo Hyun Sohn Ju Yeon Cho Yoon Jun Kim Jin Mo Yang Jung Gil Park Won Kim Hyun Chin Cho Dong Joon Kim |
| author_sort | Jung Hee Kim |
| collection | DOAJ |
| description | Background/Aims Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD based on the aetiology of CLD, encompassing LC. However, limited research has been conducted to analyse these discrepancies across aetiologies.Methods The prospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort consisted of 1,501 patients who were hospitalized with AD of CLD from July 2015 to August 2018. In this study, we assess the clinical attributes and prognostic implications of AD with CLD/LC stratified by the aetiology.Results Among 1,501 patients, the mean age was 54.7 years old and 1,118 patients (74.5%) were men. The common events of AD were GI bleeding (35.3%) and jaundice (35.0%). There was a median follow-up of 8.0 months (1.0–16.0 months). The most common aetiology of CLD was alcohol (n = 1021), followed by viral hepatitis (n = 206), viral hepatitis with alcohol-related (n = 129), cryptogenic (n = 108) and autoimmune (n = 37). Viral hepatitis with alcohol-related CLD showed a poor liver function profile and a high frequency of acute-on-chronic liver failure (ACLF) [22.1% vs. 19.6% (alcohol CLD), 8.1% (viral CLD), 5.6% (autoimmune related CLD and 16.0% (cryptogenic CLD)] with worse adverse outcomes (mortality or liver transplantation) than other aetiologies. The difference in aetiology was a significant factor for 28-day adverse outcomes in multivariate analysis even in a high MELD score (≥15), which indicated poor baseline liver function and prognosis (p < 0.001).Conclusion The aetiology of CLD constitutes a pivotal determinant influencing both short- and long-term adverse outcomes of AD in CLD, even among individuals presenting with elevated MELD scores. Notably, patients afflicted with viral hepatitis should exercise caution even in the consumption of modest quantities of alcohol that induced the exacerbations in the adverse outcomes associated with AD. |
| format | Article |
| id | doaj-art-44af5bcb5c5e450cb4a2f6cec739ad5e |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-44af5bcb5c5e450cb4a2f6cec739ad5e2025-01-25T04:12:01ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2024.2428431Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational studyJung Hee Kim0Sung-Eun Kim1Do Seon Song2Hee Yeon Kim3Eileen L. Yoon4Ji Won Park5Tae Hyung Kim6Young-Kul Jung7Ki Tae Suk8Hyung Joon Yim9Jung Hyun Kwon10Sung Won Lee11Seong Hee Kang12Moon Young Kim13Soung Won Jeong14Jae-Young Jang15Jeong Ju Yoo16Sang Gyune Kim17Young-Joo Jin18Gab Jin Cheon19Byung Seok Kim20Yeon Seok Seo21Hyoungsu Kim22Dong Hyun Sinn23Woo Jin Chung24Hwi Young Kim25Han Ah Lee26Seung Woo Nam27In Hee Kim28Ji Hoon Kim29Hee Bok Chae30Joo Hyun Sohn31Ju Yeon Cho32Yoon Jun Kim33Jin Mo Yang34Jung Gil Park35Won Kim36Hyun Chin Cho37Dong Joon Kim38Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, Hanyang University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Internal Medicine, Korea University Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Korea University Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Internal Medicine, Korea University Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, Korea University Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of KoreaDepartment of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of KoreaDepartment of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of KoreaDepartment of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of KoreaDepartment of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of KoreaDepartment of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of KoreaDepartment of Internal Medicine, Korea University Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of KoreaDepartment of Internal Medicine, National Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Republic of KoreaDepartment of Internal Medicine, Korea University Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Republic of KoreaDepartment of Internal Medicine, Hanyang University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of KoreaDepartment of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of KoreaDepartment of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Gyeongsang National University Hospital, Jinju, Republic of KoreaDepartment of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of KoreaBackground/Aims Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD based on the aetiology of CLD, encompassing LC. However, limited research has been conducted to analyse these discrepancies across aetiologies.Methods The prospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort consisted of 1,501 patients who were hospitalized with AD of CLD from July 2015 to August 2018. In this study, we assess the clinical attributes and prognostic implications of AD with CLD/LC stratified by the aetiology.Results Among 1,501 patients, the mean age was 54.7 years old and 1,118 patients (74.5%) were men. The common events of AD were GI bleeding (35.3%) and jaundice (35.0%). There was a median follow-up of 8.0 months (1.0–16.0 months). The most common aetiology of CLD was alcohol (n = 1021), followed by viral hepatitis (n = 206), viral hepatitis with alcohol-related (n = 129), cryptogenic (n = 108) and autoimmune (n = 37). Viral hepatitis with alcohol-related CLD showed a poor liver function profile and a high frequency of acute-on-chronic liver failure (ACLF) [22.1% vs. 19.6% (alcohol CLD), 8.1% (viral CLD), 5.6% (autoimmune related CLD and 16.0% (cryptogenic CLD)] with worse adverse outcomes (mortality or liver transplantation) than other aetiologies. The difference in aetiology was a significant factor for 28-day adverse outcomes in multivariate analysis even in a high MELD score (≥15), which indicated poor baseline liver function and prognosis (p < 0.001).Conclusion The aetiology of CLD constitutes a pivotal determinant influencing both short- and long-term adverse outcomes of AD in CLD, even among individuals presenting with elevated MELD scores. Notably, patients afflicted with viral hepatitis should exercise caution even in the consumption of modest quantities of alcohol that induced the exacerbations in the adverse outcomes associated with AD.https://www.tandfonline.com/doi/10.1080/07853890.2024.2428431Chronic liver diseaseliver cirrhosisacute decompensationaetiology |
| spellingShingle | Jung Hee Kim Sung-Eun Kim Do Seon Song Hee Yeon Kim Eileen L. Yoon Ji Won Park Tae Hyung Kim Young-Kul Jung Ki Tae Suk Hyung Joon Yim Jung Hyun Kwon Sung Won Lee Seong Hee Kang Moon Young Kim Soung Won Jeong Jae-Young Jang Jeong Ju Yoo Sang Gyune Kim Young-Joo Jin Gab Jin Cheon Byung Seok Kim Yeon Seok Seo Hyoungsu Kim Dong Hyun Sinn Woo Jin Chung Hwi Young Kim Han Ah Lee Seung Woo Nam In Hee Kim Ji Hoon Kim Hee Bok Chae Joo Hyun Sohn Ju Yeon Cho Yoon Jun Kim Jin Mo Yang Jung Gil Park Won Kim Hyun Chin Cho Dong Joon Kim Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study Annals of Medicine Chronic liver disease liver cirrhosis acute decompensation aetiology |
| title | Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study |
| title_full | Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study |
| title_fullStr | Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study |
| title_full_unstemmed | Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study |
| title_short | Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study |
| title_sort | aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation prospective observational study |
| topic | Chronic liver disease liver cirrhosis acute decompensation aetiology |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2024.2428431 |
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