El consumo de alcohol está asociado con la insuficiencia hepática aguda sobre crónica en pacientes hispanos

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dc.coverageDOI: 10.1016/j.gastrohep.2023.09.006
dc.creatorIdalsoaga, Francisco
dc.creatorDíaz, Luis Antonio
dc.creatorFuentes-López, Eduardo
dc.creatorAyares, Gustavo
dc.creatorValenzuela, Francisco
dc.creatorMeza, Victor
dc.creatorManzur, Franco
dc.creatorSotomayor, Joaquín
dc.creatorRodriguez, Hernán
dc.creatorChianale, Franco
dc.creatorVillagrán, Sofía
dc.creatorSchalper, Maximiliano
dc.creatorVillafranca, Pablo
dc.creatorVeliz, Maria Jesus
dc.creatorUribe, Paz
dc.creatorPuebla, Maximiliano
dc.creatorBustamante, Pablo
dc.creatorAguirre, Herman
dc.creatorBusquets, Javiera
dc.creatorRoblero, Juan Pablo
dc.creatorMezzano, Gabriel
dc.creatorHernandez-Tejero, Maria
dc.creatorArrese, Marco
dc.creatorArab, Juan Pablo
dc.date2024
dc.date.accessioned2025-11-18T19:52:43Z
dc.date.available2025-11-18T19:52:43Z
dc.description<p>Background: Acute-on-chronic liver failure (ACLF) is a severe clinical entity associated with elevated short-term mortality. We aimed to characterize patients with decompensated cirrhosis according to presence of ACLF, their association with active alcohol intake, and long-term survival in Latin America. Methods: Retrospective cohort study of decompensated cirrhotic in three Chilean university centers (2017-2019). ACLF was diagnosed according EASL-CLIF criteria. We assessed survival using competing-risk and time-to-event analyses. We evaluated the time to death using accelerated failure time (AFT) models. Results: We included 320 patients, median age of 65.3 ± 11.7 years old, and 48.4% were women. 92 (28.7%) patients met ACLF criteria (ACLF-1: 29.3%, ACLF-2: 27.1%, and ACLF-3: 43.4%). The most common precipitants were infections (39.1%), and the leading organ failure was kidney (59.8%). Active alcohol consumption was frequent (27.7%), even in patients with a prior diagnosis of non-alcoholic fatty liver disease (NAFLD) (16.2%). Ninety-two (28.7%) patients had ACLF (ACLF-1: 8.4%, ACLF-2: 7.8%, and ACLF-3: 12.5%). ACLF patients had a higher MELD-Na score at admission (27 [22-31] versus 16 [12-21], p &lt; 0.0001), a higher frequency of alcohol-associated liver disease (36.7% versus 24.9%, p = 0.039), and a more frequent active alcohol intake (37.2% versus 23.8%, p = 0.019). In a multivariate model, ACLF was associated with higher mortality (subdistribution hazard ratio 1.735, 95%CI: 1.153-2.609; p &lt; 0.008). In the AFT models, the presence of ACLF during hospitalization correlated with a shorter time to death: ACLF-1 shortens the time to death by 4.7 times (time ratio [TR] 0.214, 95%CI: 0.075-0.615; p &lt; 0.004), ACLF-2 by 4.4 times (TR 0.224, 95%CI: 0.070-0.713; p &lt; 0.011), and ACLF-3 by 37 times (TR 0.027, 95%CI: 0.006-0.129; p &lt; 0.001). Conclusions: Patients with decompensated cirrhosis and ACLF exhibited a high frequency ofactive alcohol consumption. Patients with ACLF showed higher mortality and shorter time todeath than those without ACLF.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/7e3f9d78-d795-410d-8e3b-458f937042db
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/57866
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.47 (2024) date: 2024-06-01 nr.6 p.562-573
dc.subjectAlcohol
dc.subjectChronic liver disease
dc.subjectCirrhosis
dc.subjectNAFLD
dc.titleEl consumo de alcohol está asociado con la insuficiencia hepática aguda sobre crónica en pacientes hispanosspa
dc.titleActive alcohol consumption is associated with acute-on-chronic liver failure in Hispanic patientseng
dc.typeArticleeng
dc.typeArtículospa
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