Table 2

Clinical and laboratory data at ACLF diagnosis, clinical course and mortality in patients with and without bacterial infection at diagnosis or during follow-up*

Bacterial infection at ACLF diagnosis (n=152)No bacterial infection at ACLF diagnosis (n=255)Bacterial infection during follow-up† (n=117)No bacterial infection during follow-up† (n=138)
Cause of admission
 GI bleeding7 (8.3)26 (19.7)¶14 (21.2)12 (18.2)
 Infection31 (36.9)25 (18.9)**16 (24.2)9 (13.6)
 Encephalopathy10 (11.9)33 (25.0)¶20 (30.3)13 (19.7)
 HRS2 (2.4)7 (5.3)2 (3.0)5 (7.6)
 Ascites19 (22.6)27 (20.5)9 (13.6)18 (27.3)
 Other15 (17.9)14 (10.6)5 (7.6)9 (13.6)
Clinical and laboratory data
 Age (years)56±1356±1154±1157±11¶
 Alcoholic cirrhosis (%)80 (53.7)148 (61.4)63 (57.8)85 (64.4)
 No prior decompensation (%)43 (29.7)53 (22.3)25 (22.3)28 (22.2)
 Ascites with surrogates (%)147 (96.7)252 (98.8)116 (99.2)136 (98.6)
 Encephalopathy (%)83 (61.0)111 (50.2)¶62 (60.8)49 (41.2)**
 WBC (x109/L)9.9 (6.1–15.4)6.8 (4.6–11.7)††7.5 (5.0–13.2)6.5 (4.6–9.9)¶
 Serum CRP (mg/L)36 (21–77)25 (11–46)††29 (16–51)19 (9–40)¶
 Serum bilirubin (mg/dL)6.8 (3.3–14.6)8.5 (2.6–19.4)11.0 (2.7–22)6.6 (2.5–16.5)
 INR1.9 (1.5–2.7)1.9 (1.4–2.6)2.0 (1.5–2.5)1.8 (1.4–2.6)
 Serum creatinine (mg/dL)1.7 (1.0–2.6)1.9 (1.0–2.6)1.9 (1.1–3.0)1.8 (0.9–2.4)
 Plasma sodium (mEq/L)134±7135±6135±6134±6
 Serum albumin (g/dL)2.8 (2.4–3.2)2.9 (2.5–3.4)2.9 (2.6–3.3)2.9 (2.5–3.5)
 Renal failure (%)72 (52.2)112 (50.9)52 (51.5)60 (50.4)
 Cerebral failure (%)42 (30.9)38 (17.2)**24 (23.3)14 (11.9)¶
 Respiratory failure (%)25 (20.5)18 (10.2)¶13 (15.7)5 (5.4)¶
 Circulatory failure (%)45 (34.1)39 (18.0)††22 (22.2)17 (14.4)
 Coagulation failure (%)52 (39.1)65 (30.5)27 (27.6)38 (33.0)
 Liver failure (%)48 (35.0)93 (42.9)46 (46.0)47 (40.2)
 MELD score28±727±728±727±7
 CLIF-C ACLF score54±1148±9**50±946±9¶
 NASCELD criteria for ACLF‡22 (14.5)22 (8.6)17 (14.5)5 (3.6)**
 ACLF-1(%)71 (46.7)133 (52.2)50 (42.7)83 (60.1)††
 ACLF-2(%)52 (34.2)95 (37.3)45 (38.5)50 (36.2)
 ACLF-3(%)29 (19.1)27 (10.6)22 (18.8)5 (3.6)
Inflammatory cytokines
 TNF (pg/ml)37 (26–50)29 (17–39)**31 (18–42)25 (15–35)¶
 IL-6 (pg/ml)101 (34–466)29 (13–75)††(16–100)26 (11–43)¶
 IL-8 (pg/ml)117 (66–225)75 (38–165)**87 (45–165)60 (32–169)
 IL-10 (pg/ml)18 (7–58)6 (2–19)††7 (3–34)4 (1–14)**
 IL-1ra (pg/ml)39 (14–108)16 (8–42)**23 (9–57)14 (7–30)¶
Albumin oxidation fractions§
 HMA (%)42 (30–58)46 (34–58)42 (33–58)48 (35–56)
 HNA1+HNA2 (%)56 (42–68)52 (41–64)51 (41–65)52 (43–64)
 HNA2 (%)11(8–15)11 (6–15)12 (7–17)8 (5–12)¶
Need for critical care (28 days)
 ICU95 (62.5)112 (43.9)††66 (56.4)46 (33.3)††
 Mechanical ventilation58 (38.2)56 (22.0)††41 (35.0)15 (10.9)††
 Renal replacement therapy51 (33.6)55 (21.6)**31 (26.5)24 (17.4)
 NASCELD criteria for ACLF‡63 (41.5)63 (24.7)††46 (39.3)17 (12.3)††
Clinical course of ACLF
 No ACLF or ACLF-1 at final assessment74 (51.0)151 (64.8)**61 (54.5)90 (74.4)**
 ACLF 2–3 at final assessment71 (49.0)82 (35.2)51 (45.5)31 (25.6)
28-day transplant-free mortality54 (35.5)71 (27.8)45 (38.5)26 (18.8)††
90-day transplant free mortality77 (50.7)98 (38.4)¶60 (51.3)38 (27.5)††
  • *Patients are divided in two groups: A: patients with and without bacterial infections at diagnosis of ACLF, B: patients with ACLF without bacterial infections at diagnosis who did and did not develop bacterial infections during follow-up.

  • †Patients with ACLF and bacterial infection at diagnosis of the syndrome were excluded from this analysis.

  • ‡Two or more of the following: vasopressors, renal replacement therapy, mechanical ventilation, grade 3–4 hepatic encephalopathy.

  • §According to the redox state at cysteine 34.

  • ¶p Value<0.05.

  • **p Value<0.01.

  • ††p Value<0.001.

  • ACLF, acute-on-chronic liver failure; CLIF, chronic liver failure in cirrhosis; CRP, C reactive protein; GI, gastrointestinal; HMA, human mercaptalbumin; HRS, hepatorenal syndrome; ICU, intensive care unit; IL, interleukin; MELD, Model for End-Stage Liver Disease; NASCELD, North American Consortium for the Study of End-Stage Liver Disease; TNF, tumour necrosis factor; WBC, white blood cell, INR: international normalized ratio.