{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T04:27:27Z","timestamp":1746332847614,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T00:00:00Z","timestamp":1498694400000},"content-version":"vor","delay-in-days":59,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81170421","81470869"],"award-info":[{"award-number":["81170421","81470869"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Acute\u2010on\u2010chronic liver failure (<jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content>) is a distinct syndrome that develops in patients with cirrhosis and acute decompensation (<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>). This study focused on the precipitating events (<jats:styled-content style=\"fixed-case\">PEs<\/jats:styled-content>) of hepatitis <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content> virus (<jats:styled-content style=\"fixed-case\">HBV)<\/jats:styled-content>\u2010related cirrhotic patients diagnosed as <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> based on the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hronic <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>iver <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ailure <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>onsortium organ failure <jats:styled-content style=\"fixed-case\">(CLIF\u2010C OF)<\/jats:styled-content> score.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Hospitalized patients with <jats:styled-content style=\"fixed-case\">HBV\u2010related<\/jats:styled-content> cirrhosis and <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> were retrospectively included. The patients\u2019 characteristics, laboratory test results, <jats:styled-content style=\"fixed-case\">PEs, CLIF\u2010C OF<\/jats:styled-content> score and short\u2010term prognosis were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of the 890 patients enrolled 300 (33.7%) were diagnosed as <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> and 590 (66.3%) without <jats:styled-content style=\"fixed-case\">ACLF. ACLF patients had a higher incidence of PEs<\/jats:styled-content> than those without <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content>. The <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> patients were more prone to having <jats:styled-content style=\"fixed-case\">PEs<\/jats:styled-content> of bacterial infection (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> reactivation (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), active alcoholism (<jats:italic>P<\/jats:italic>\u2009=\u20090.036) and superimposed hepatitis virus infection (<jats:italic>P<\/jats:italic>\u2009=\u20090.031), whereas portal vein thrombosis (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) were less common in the non\u2010<jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> group. <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> patients with the top four single <jats:styled-content style=\"fixed-case\">PEs<\/jats:styled-content> had diverse types of organ failures. However, they shared a similar short\u2010term prognosis. While in patients without <jats:styled-content style=\"fixed-case\">PEs<\/jats:styled-content> the <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> group had higher systemic inflammation and deterirated outcomes compared with the non\u2010<jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> group.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>\n<jats:styled-content style=\"fixed-case\">PEs<\/jats:styled-content> of bacterial infection, <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> reactivation, active alcoholism and superimposed hepatitis virus infection, but not <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> hemorrhage or portal vein thrombosis, were risk factors for <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content>. There may be two types of patients with <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> based on the differences in the clinical manifestation of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.12480","type":"journal-article","created":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T06:02:41Z","timestamp":1494309761000},"page":"292-301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Risk of different precipitating events for progressing to acute\u2010on\u2010chronic liver failure in <scp>HBV<\/scp>\u2010related cirrhotic patients"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9483-6615","authenticated-orcid":false,"given":"Shan","family":"Yin","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi Jin","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen Yi","family":"Gu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease  Shanghai 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