To Study the Etiology and Predicting Scores of Patients with acute on chronic liver failure

Abstract

Aim: To study the aetiology, precipitating insults of patients presenting with acute on chronic liver failure and predictors of mortality of acute chronic liver failure. Methods: The prospective study was carried out in 100 patients admitted with acute on chronic liver failure for a period of 1 year in the Department of Medicine of Government medical college and Hospital, Jammu. Results: ACLF has a predominant male preponderance i.e 92 %. The mean age of patients presenting with ACLF was 45.39 ± 1.1 yrs. Among causes of chronic liver disease alcohol was commonest (79 %) followed by Alcohol + Hepatitis C (4.0 %) ,Alcohol + hepatitis B (1 %), Hepatitis B (1 %), Hepatitis C (3 %), NASH related (4 %) and Auto immune (5 %).Etiologyof acute precipitants included alcohol (43%) followed by Alcohol with Hepatitis B/C (9 %), alcohol with Hepatitis E (4%), alcohol with hepatitis E + Dengue (2%), Hepatitis E (8%), Hepatitis B (8 %) and Hepatitis C (6%) ,Hepatitis E + Leptospirosis (2%), leptospirosis (1%) and gastrointestinal bleed + others etiology (14%) were other causes of acute etiology in patients of acute on chronic liver failure. The mean SOFA, MELD and MDF scores were found to be better predictors of mortality. Conclusion: ACLF carries a high mortality rate. Alcohol was found to be the most common cause of chronic etiology of Chronic liver disease as well as acute insult. Scoring systems such as SOFA, MELD and MDF scores were considered to better predictors of mortality.