Clinical profile of patients with acute-on-chronic liver failure

Abstract

ACLF is a distinct clinical entity and different from acute liver failure or chronic liver disease as here two simultaneous but different insults are operating: acute insult and chronic insult. Like acute liver failure ACLF is also associated with high mortality rate, liver support device are important therapeutic options for these patients to provide them additional time for recovery or to serve as a “bridge” to transplantation, whereas orthotopic liver transplantation remains the only definitive therapy who do not improve with supportive measures. Patients with acute-on-chronic liver failure (ACLF) admitted in Medicine or Hepatology ward were enrolled for the study. The most frequent symptoms reported by the patients with ACLF in our study were Jaundice 60(100%) and abdominal distension (ascites) 55 (91%). Other symptoms were altered sensorium (encephalopathy) 36(60%), anorexia 34(56%), fatigue 25(41%), pedal edema 20(33.3%), clinically palpable speen 22(36.6), fever 12(20%) abdominal pain & GI bleeding each 08(13.3%). Among the GI bleeding patients 2 patients had Hematemesis only, 6 patients had only malena & 1 patient had both. Among HE patients 13(21%) had grade 1-2 HE & remaining 23(38%) patients had grade 3-4 hepatic encephalopathy.