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Cheng J, Huang K, Mou JL, Lao YJ, Feng JH, Hu F, Lin ML, Maimaitiaishan T, Shang J, Lin J. Prognosis value of serum chloride on 1-year mortality in cirrhotic patients receiving transjugular intrahepatic portosystemic shunt. J Formos Med Assoc 2023; 122:911-921. [PMID: 36878767 DOI: 10.1016/j.jfma.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/09/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND AND PURPOSE Emerging researches have regarded serum chloride as a capable predictor of mortality in liver cirrhosis. We aim to investigate the clinical role of admission chloride in cirrhotic patients with esophagogastric varices receiving transjugular intrahepatic portosystemic shunt (TIPS), which is unclear. METHODS We retrospectively analyzed data of cirrhotic patients with esophagogastric varices undergoing TIPS in Zhongnan Hospital of Wuhan University. Mortality outcome was obtained by following up for 1-year after TIPS. Univariate and multivariate Cox regression were used to identify independent predictors of 1-year mortality post-TIPS. The receiver operating characteristic (ROC) curves were adopted to assess the predictive ability of the predictors. In addition, log-rank test and Kaplan-Meier (KM) analyses were employed to evaluate the prognostic value of predictors in the survival probability. RESULTS A total of 182 patients were included ultimately. Age, fever symptom, platelet-to lymphocyte-ratio (PLR), lymphocyte-to-monocyte ratio (LMR), total bilirubin, serum sodium, chloride, and Child-Pugh score were related to 1-year follow-up mortality. In multivariate Cox regression analysis, serum chloride (HR = 0.823, 95%CI = 0.757-0.894, p < 0.001) and Child-Pugh score (HR = 1.401, 95%CI = 1.151-1.704, p = 0.001) were identified as independent predictors of 1-year mortality. Patients with serum chloride <107.35 mmol/L showed worse survival probability than those with serum chloride ≥107.35 mmol/L no matter with or without ascites (p < 0.05). CONCLUSION Admission hypochloremia and increasing Child-Pugh score are independent predictors of 1-year mortality in cirrhotic patients with esophagogastric varices receiving TIPS.
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Affiliation(s)
- Jie Cheng
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Kai Huang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Juan-Li Mou
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Yao-Jia Lao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Jia-Hui Feng
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Fan Hu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Meng-Lu Lin
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Tangnuer Maimaitiaishan
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Jian Shang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China
| | - Jun Lin
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China; The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, 430071, PR China.
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Kim JD. [Acute Liver Failure: Current Updates and Management]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2023; 81:17-28. [PMID: 36695063 DOI: 10.4166/kjg.2022.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 12/25/2022] [Accepted: 12/29/2022] [Indexed: 01/26/2023]
Abstract
Acute liver failure (ALF) is a rare disease condition with a dynamic clinical course and catastrophic outcomes. Several etiologies are involved in ALF. Hepatitis A and B infections and indiscriminate use of untested herbs or supplemental agents are the most common causes of ALF in Korea. Noninvasive neurological monitoring tools have been used in patients with ALF in recent times. Ongoing improvements in intensive care, including continuous renal replacement therapy, therapeutic plasma exchange, vasopressor, and extracorporeal membrane oxygenation, have reduced the mortality rate of patients with ALF. However, liver transplantation is still the most effective treatment for patients with intractable ALF. There is a need for further research in the areas of better prognostication and precise selection of patients for emergency transplantation.
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Affiliation(s)
- Jin Dong Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
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