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RISS 인기검색어
- 검색키워드
- 저자 : ( Ashok Kumar Choudhury ) (검색결과 3 건)
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( Priyanka Jain ),( Saggere Muralikrishna Shasthry ),( Ashok Kumar Choudhury ),( Rakhi Maiwall ),( Guresh Kumar ),( Ankit Bharadwaj ),( Vinod Arora ),( Rajan Vijayaraghavan ),( Ankur Jindal ),( Manoj 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1
Background/Aims: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. Methods: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. Results: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2-10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40-50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. Conclusions: One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age. (Clin Mol Hepatol 2021;27:175-185)
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( Do Seon Song ),( Dong Joon Kim ),( Ji Dong Jia ),( Ashok Kumar Choudhury ),( Mamun Al Mahtab ),( Harshad Devarbhavi ),( Z Duan ),( Chen Yu ),( C E Eapen ),( Ashish Goel ),( Q Ning ),( Ke Ma ),( Y K 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: To compare the existing various prognostic scoring mod els and newly proposed scores for acute-on-chronic liver failure (ACLF) and evaluate usefulness of stratification for the predic tion of short-term morality in patients with alcoholic hepatitis (AH). Methods: A total of 705 clinical AH patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day fol low-up, were analyzed. AARC-ACLF score, Maddrey discrimina tion function (DF) score, age, bilirubin, international normalized ratio and creatinine score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), Child-Turcott-Pugh (CTP) score, model for end-stage liver disease (MELD), and MELD-Sodium (Na) scores were used to compare the performance for predicting 30-day and 90-day mortality. AARC-ACLF scores were categorized into three grades (Gr I: 5-7; II: 8-10; and III: 11-15 points) and sur vival curves by the Kaplan-Meier method were created and compared using log-rank test. Results: Of 708 patients, 286 (40.4%) and 363 (51.3%) pa tients died within 30 days and 90 days, respectively. The area under receiver operating characteristics curve (AUC) of AARC-ACLF, DF, ABIC, GAHS, CTP, MELD, and MELD-Na was 0.752 (0.705-0.799), 0.630 (0.575-0.685), 0.658 (0.604-0.711), 0.577 (0.523-0.631), 0.641 (0.589-0.694), 0.705 (0.653-0.756), 0.703 (0.651-0.755), respectively, for 30-day mortality. The AUC of various prognostic scores for the prediction of 90-day mortality is similar. The performance of AARC-ACLF was superior to that of DF, ABIC, GAHS, CTP, while comparable to that of MELD and MELD-Na in predicting short-term mortality. According to AARC-ACLF grades, short-term cumulative survivals was statis tically different (30-day, 82.4, 70.4, and 35.3%, P<0.001; 90- day, 76.9, 56.0, and 26.4%, P<0.001). Conclusions: Compared to the previous AH prognostic scores, AARC-ACLF score and grades are simple and useful for predict ing the short-term mortality in patients with AH. Further studies are needed to confirm these implications.
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( Do Seon Song ),( Tae Yeob Kim ),( Hee Yeon Kim ),( Eileen L. Yoon ),( Dong Joon Kim ),( Ji Dong Jia ),( Ashok Kumar Choudhury ),( Mamun Al Mahtab ),( Harshad Devarbhavi ),( Z Duan ),( Chen Yu ),( C 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Asian Pacific Association for the Study of Liver (APASL) acute-on-chronic liver failure (ACLF) Research Consortium (AARC) proposed new prognostic scoring system of ACLF in cluding lactate. However, lactate is not routinely checked in clinical practice of patient with ACLF in Korea. Therefore, we aimed to investigate the predictive accuracy of lactate-free AARC-ACLF score for predicting short-term mortality in patients with alcoholic liver disease. Methods: A total of 749 ALD patients who had liver failure (bilirubin≥5mg/dL and INR≥1.5) in AARC database were in vestigated. Diagnostic performances for short-term mortality were compared according to the area under receiver operating characteristic (AUROC) curve. Predictive accuracy of lactate-free AARC-ACLF score were compared with other prognostic scores in 143 ALD patients with liver failure and 60 ALD patients with ACLF according to AARC definition in Korean ACLF cohort. Results: Among 749 patients, 30-day and 90-day mortality were 40.3% and 51.5%. There were no significant differences in AUROC for predicting 30-day and 90-day mortality between AARC-ACLF score and lactate-free AARC-ACLF score (30-day mortality: 0.752 vs. 0.751, P=0.918, 90-day mortality: 0.728 vs. 0.736, P=0.346). In Korean ACLF cohort, the AUROCs of lactate-free AARC-ACLF score for predicting 28-day and 90- day mortality were 0.861 and 0.846 in ALD with liver failure, and 0.884 and 0.874 in ALD patients with ACLF according to AARC definition, respectively. In Korean ALD patients with liver failure and ACLF according to AARC definition, diagnostic per formance of lactate-free AARC-ACLF score for predicting 28- day and 90-day mortality was comparable to those of Model for End-stage Liver Disease (MELD), MELD-Na, Chronic Liver Failure-Sequential Organ Failure Assessment score. Conclusions: Lactate-free AARC-ACLF score is as excellent as AARC-ACLF score in predicting short-term mortality in ALD patients with liver failure of AARC database and Korean ACLF cohort.
KCI
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