Acute-on-chronic Liver Failure (ACLF)
Conditions
Interventions
Control group:standardized treatment according to the typical course of acute decompensation of liver cirrhosis.
Treatment group:“Pre-ACLF screening” Kit Identification and Management Strategies
Sponsors
Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Age = 18 years and = 80 years; 2. Patients with chronic liver diseases including liver cirrhosis (diagnosed by CT/MRI imaging or based on past medical history); 3. Acute decompensation within 1 month (2-5 must still exist at the time of admission): 1) Upper gastrointestinal bleeding (black tarry stools + fecal occult blood [++]) 2) Manifest ascites (B-ultrasound depth > 5 cm) 3) Hepatic encephalopathy 4) Infection at a definite site 5) Jaundice (TB > 5 mg/dL); 4. The test result of "pre-ACLF screening" kit is greater than 0.23;
Exclusion criteria
Exclusion criteria: 1. Exclusion criteria: 1. Patients diagnosed with ACLF by the CATCH-LIFE criteria, that is, any of the following conditions: 1) TB > 20mg/dL; 2) Creatinine (Cr) > 2mg/DL or undergoing renal replacement therapy; 3) Hepatic encephalopathy = grade 3 and TB > 6mg/dL; 4) INR > 2.1; 5) SpO2/FiO2 = 214 or requiring mechanical ventilation; 6) Using vasoconstrictor drugs; 2. Presence of malignant tumors in the liver or in other extraliver organs; 3. Other severe comorbidities exist, such as heart failure, respiratory failure, chronic kidney disease, stroke or heart attack within the past six months, severe autoimmune diseases or metabolic disorders, etc. 4. Pregnant women and lactating women; 5. Long-term use of immunosuppressants due to non-liver disease causes.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 90-day mortality; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence rate of ACLF within 28 days;7d, 14d, 21d, 28d MELD score, MAP score, and Child-Pugh score;Mortality rates within 28 days, 90 days, and 180 days; Liver transplantation rates;The re-admission rate due to AD within 90 days after discharge;Incidence rates of adverse outcomes within 28 days and 90 days;28-day, 180-day mortality; | — |
Countries
China
Contacts
Public ContactHai Li
Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine
Outcome results
None listed