Clinical characteristics of patients
| Characteristics | ACLF (n=130) | ACHD (n=70) | LC (n=70) | CHB (n=70) | NC (n=60) |
| Age (years) | 44.5 (36.2, 55.0) | 41.5 (36.0, 51.7) | 46.0 (40.0, 52.5) | 43.5 (38.0, 50.0) | 46.5 (33.8, 53.0) |
| Male (No.) | 86.2% (112) | 81.4% (57) | 74.3% (52) | 77.1% (54) | 56.7% (34) *** |
| HBV DNA level (IU/mL) | Significance† | Significance† | Significance† | ||
| ≤2×102 | 5.4% (7) | 22.8% (16) | 91.4% (64) | 81.4% (57) | NA |
| 2×102–2×106 | 66.9% (87) | 52.9% (37) | 8.6% (6) | 12.9% (9) | NA |
| >2×106 | 27.7% (36) | 24.3% (17) | 0.0% (0) | 5.7% (4) | NA |
| Laboratory data | |||||
| Alanine aminotransferase (U/L) | 252.0 (93.0, 592.0) | 160.0 (60.3, 556.0) | 24.5 (18.0, 32.0)*** | 23.2 (17.0, 29.8)*** | 19.0 (14.0, 25.0)*** |
| Aspartate aminotransferase (U/L) | 147.5 (101.3, 290.8) | 115.0 (59.8, 261.8)* | 23.5 (19.3, 29.8)*** | 22.0 (20.0, 26.8)*** | 20.0 (18.0, 25.0)*** |
| Albumin (g/L) | 31.5 (28.5, 33.8) | 32.4 (29.9, 36.0)* | 47.6 (45.6, 48.8)*** | 48.7 (46.5, 51.1)*** | 47.7 (46.1, 49.1)*** |
| Total bilirubin (µmol/L) | 352.5 (262.9, 437.9) | 179.9 (120.0, 286.3)*** | 13.2 (11.0, 17.0)*** | 13.0 (9.2, 16.0)*** | 11.0 (8.5, 14.0)*** |
| Alkaline phosphatase (U/L) | 137.0 (110.5, 166.0) | 118.0 (99.3, 143.8)** | 70.0 (58.3, 90.0)*** | 64.5 (50.5, 79.8)*** | 67.0 (55.0, 84.0)*** |
| γ-glutamyl transpeptidase (U/L) | 77.8 (56.0, 115.4) | 88.6 (49.5, 135.7) | 22.0 (17.0, 37.8)*** | 20.5 (13.0, 32.8)*** | 19.0 (12.8, 27.0)*** |
| Creatinine (μmol/L) | 67.0 (58.0, 80.8) | 66.0 (58.0, 76.0) | 70.5 (62.7, 81.0) | 75.0 (65.0, 85.0) | 70.5 (57.7, 81.0) |
| Sodium (mmol/L) | 137.0 (135.0, 139.0) | 138.0 (137.0, 140.0)** | 141.0 (140.0, 142.0)*** | 141.0 (140.0, 143.0)*** | 141.0 (140.0, 143.0)*** |
| White blood cell count (109/L) | 7.6 (6.1, 10.3) | 6.1 (4.2, 7.6)*** | 5.1 (4.0, 6.3)*** | 5.5 (4.7, 6.3)*** | 6.1 (5.4, 6.9)*** |
| Haemoglobin (g/L) | 125.0 (116.2, 136.0) | 133.0 (115.5, 143.7) | 153.0 (142.5, 158.8)*** | 151.0 (140.0, 162.0)*** | 149.0 (136.8, 160.0)*** |
| Haematocrit (%) | 35.6 (32.5, 38.9) | 37.6 (32.6, 42.5)* | 45.5 (42.9, 47.3)*** | 44.5 (41.2, 46.9)*** | 44.1 (40.7, 47.6)*** |
| Platelet count (109/L) | 112.0 (74.0, 145.0) | 141.0 (76.5, 186.0) | 155.5 (117.0, 207.8)*** | 174.0 (139.0, 214.0) *** | 218.5 (188.5, 257.2)*** |
| INR | 2.3 (1.8, 3.0) | 1.4 (1.2, 1.7)*** | 1.0 (1.0, 1.1)*** | 1.0 (0.9, 1.1)*** | NA |
| Alpha fetoprotein (μg/L) | 88.8 (34.8, 235.3) | 62.4 (5.7, 301.6) | 2.2 (1.8, 2.8)*** | 2.5 (1.9, 3.4)*** | 2.8 (2.0, 4.0)*** |
| Organ failure (No.) | |||||
| Liver | 94.6% (123) | 35.7% (25)*** | 0*** | 0*** | 0*** |
| Coagulation | 42.3% (55) | 5.7% (4)*** | 0*** | 0*** | 0*** |
| Kidney | 6.2% (8) | 0 | 0 | 0 | 0 |
| Cerebral | 7.7% (10) | 0* | 0 * | 0* | 0* |
| Lung | 1.5% (2) | 0 | 0 | 0 | 0 |
| Circulation | 0.8% (1) | 0 | 0 | 0 | 0 |
| Severity score | |||||
| COSSH-ACLFs | 6.2 (5.7, 6.8) | NA | NA | NA | NA |
| CLIF-C ACLFs | 42.0 (37.4, 45.9) | NA | NA | NA | NA |
| MELD | 24.6 (20.7, 28.6) | NA | NA | NA | NA |
| Transplant-free mortality rate (number of deceased patients)‡ | |||||
| 28-day | 33.0% (37) | 2.9% (2)*** | 0*** | 0*** | NA |
| 90-day | 46.0% (47) | 2.9% (2)*** | 0*** | 0*** | NA |
Data are presented as the means±SD, medians (p25, p75) or percentages (numbers of patients).
*p<0.05, **p<0.01 and ***p<0.001 for comparisons between the ACHD/LC/CHB/NC and ACLF groups.
†P value (<0.001) for comparisons of the HBV DNA distribution between the ACHD/LC/CHB/NC and ACLF groups.
‡Twelve patients with ACLF underwent liver transplantation and were considered lost to follow-up for the mortality calculation. Six patients with ACLF were lost to the 28-day follow-up analysis and 10 patients were lost to the 90-day follow-up analysis.
ACHD, acute-on-chronic hepatic dysfunction; ACLF, acute-on-chronic liver failure; CHB, chronic hepatitis B; CLIF-C ACLFs, Chronic Liver Failure Consortium ACLF score; COSSH-ACLFs, Chinese Group on the Study of Severe Hepatitis B-ACLF score; INR, international normalised ratio; LC, liver cirrhosis; MELD, model for end-stage liver disease; NC, normal controls.