P- 36 ACUTE ON CHRONIC LIVER FAILURE IN LATIN AMERICA: SUB-ANALYSIS OF A SYSTEMATIC REVIEW AND META-ANALYSIS

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Andes, Santiago, Chile" "etiqueta" => "1" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Gastroenterología/Hepatología, Hospital del Salvador, Universidad de Chile, Hospital del Salvador, Santiago, Chile" "etiqueta" => "2" "identificador" => "aff0002" ] 2 => array:3 [ "entidad" => "Internal Medicine Resident, Universidad de los Andes, Santiago, Chile" "etiqueta" => "3" "identificador" => "aff0003" ] 3 => array:3 [ "entidad" => "Liver Unit, Hospital Clinic de Barcelona, Barcelona, Catalunya" "etiqueta" => "4" "identificador" => "aff0004" ] 4 => array:3 [ "entidad" => "Section of Gastroenterology, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, Estados Unidos (EEUU)" "etiqueta" => "5" "identificador" => "aff0005" ] ] ] ] "textoCompleto" => "<elsevierMultimedia ident="fig0001"></elsevierMultimedia>" "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "Introduction and ObjectivesAcute-on-chronic liver failure (ACLF) is characterized by acute decompensation of liver cirrhosis associated with extrahepatic organ failure, and high short-term mortality. Previous studies have estimated a global prevalence of 35% with a mortality of up to 58% at 90 days of follow-up. There is sparse data of ACLF prevalence and mortality in Latin America using the European Association for the Study of Chronic Liver Failure (EASL-CLIF) criteria. This study aimed to characterize patients with ACLF in Latin America and estimate its prevalence and mortality. Materials and MethodsPubmed from 01/03/2013 to 08/02/2023 was searched for Latin American cohort studies on ACLF, using the EASL-CLIF criteria. With the data obtained the meta-analysis was performed. ResultsSix studies were included in the analysis, with a total of 817 patients hospitalized for decompensated cirrhosis. The mean follow-up time was 69.9 ± 31.5 days. ACLF prevalence was 29.3%, where 81.5% of these patients had presented previous decompensation. The two-most common liver disease etiologies were alcohol-related liver disease (43.1%), and viral hepatitis (36.5%). The most common triggers identified were infections (35.8%), and gastrointestinal bleeding (22.9%). In up to 28% of the cases, the trigger remained unknown. The main organ disfunctions were renal failure (51.2%), and circulatory failure (45.9%). Overall ACLF mortality was 74.0%, with up to 84.4% in patients classified as ACLF 3. ConclusionsACLF is a global important health-care problem including in Latin American. The prevalence of ACLF in our study is similar to the prevalence reported worldwide, but in this region, there is a higher mortality. Our results emphasize the importance of creating local management guidelines for patients with ACLF in Latin America." 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Gabriel Mezzano1, Herman Edgardo Aguirre2, Javier Perez-Valenzuela3, Aaron Cortes1, Adria Juanola4, Andrés Cardenas4, Elsa Sola4, Ruben Hernaez5

1 Centro de Enfermedades Digestivas, Clínica Universidad de los Andes, Santiago, Chile

2 Gastroenterología/Hepatología, Hospital del Salvador, Universidad de Chile, Hospital del Salvador, Santiago, Chile

3 Internal Medicine Resident, Universidad de los Andes, Santiago, Chile

4 Liver Unit, Hospital Clinic de Barcelona, Barcelona, Catalunya

5 Section of Gastroenterology, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, Estados Unidos (EEUU)

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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Acute-on-chronic liver failure &#40;ACLF&#41; is characterized by acute decompensation of liver cirrhosis associated with extrahepatic organ failure&#44; and high short-term mortality&#46; Previous studies have estimated a global prevalence of 35&#37; with a mortality of up to 58&#37; at 90 days of follow-up&#46; There is sparse data of ACLF prevalence and mortality in Latin America using the European Association for the Study of Chronic Liver Failure &#40;EASL-CLIF&#41; criteria&#46; This study aimed to characterize patients with ACLF in Latin America and estimate its prevalence and mortality&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Methods</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Pubmed from 01&#47;03&#47;2013 to 08&#47;02&#47;2023 was searched for Latin American cohort studies on ACLF&#44; using the EASL-CLIF criteria&#46; With the data obtained the meta-analysis was performed&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Six studies were included in the analysis&#44; with a total of 817 patients hospitalized for decompensated cirrhosis&#46; The mean follow-up time was 69&#46;9 &#177; 31&#46;5 days&#46; ACLF prevalence was 29&#46;3&#37;&#44; where 81&#46;5&#37; of these patients had presented previous decompensation&#46; The two-most common liver disease etiologies were alcohol-related liver disease &#40;43&#46;1&#37;&#41;&#44; and viral hepatitis &#40;36&#46;5&#37;&#41;&#46; The most common triggers identified were infections &#40;35&#46;8&#37;&#41;&#44; and gastrointestinal bleeding &#40;22&#46;9&#37;&#41;&#46; In up to 28&#37; of the cases&#44; the trigger remained unknown&#46; The main organ disfunctions were renal failure &#40;51&#46;2&#37;&#41;&#44; and circulatory failure &#40;45&#46;9&#37;&#41;&#46; Overall ACLF mortality was 74&#46;0&#37;&#44; with up to 84&#46;4&#37; in patients classified as ACLF 3&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">ACLF is a global important health-care problem including in Latin American&#46; The prevalence of ACLF in our study is similar to the prevalence reported worldwide&#44; but in this region&#44; there is a higher mortality&#46; Our results emphasize the importance of creating local management guidelines for patients with ACLF in Latin America&#46;</p></span>"
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