Evaluation of Clinical and Laboratory Profile among Patients with Acute on Chronic Liver Disease–A Cross-Sectional Study

Acute-on-chronic liver failure (ACLF) is a clinical condition characterised by sudden hepatic decompensation, one or more extra-hepatic organ failures, and an increased risk of death in those who already have chronic liver disease [1,2] .ACLF is defined as a rapidly worsening course of a chronic liver disease that may be reversible and is either previously recognised or unknown [3] .ACLF has a high short-term mortality rate (50-90%) [4] .There are now two widely accepted working definitions of ACLF."Acute hepatic insult manifesting as jaundice (defined as serum bilirubin level >5 mg/dl) and Coagulopathies (defined as international normalised ratio >1.5), complicated within 4 weeks by ascites and/ or ABSTRACT Background: Acute-on-chronic liver failure (ACLF) is defined as an acute hepatic insult shown as jaundice and Coagulopathies, which is exacerbated within 4 weeks by ascites and/or encephalopathy in patients with previously recognised or undetected chronic liver diseases.Methods: A prospective study was done on 200 patients with an ACLF diagnosis, as well as an equal number of age-matched controls (non-ACLF).Demographic characteristics, clinical profiles, risk factors, and biochemical indicators were assessed in both ACLF and non-ACLF patients.Results: The majority of the patients (46%) were above the age of 50, with men accounting for 87%.In ACLF, alcoholic liver disease was the most common (85.7%), followed by cirrhosis caused by the Hepatitis B virus (8.2%).Jaundice was seen in all cases, followed by ascites in 94.3% of patients.Oesophageal varices (66%), Splenomegaly (60%), hepatic encephalopathy (46%), acute malnutrition (32%), hepatomegaly (30%), and fever (20%).The triggering reasons included acute flare-ups of Hepatitis B infection in 60% of patients with Hepatitis B-related cirrhosis, recent drug use (44.8%), sepsis (28.9%), spontaneous bacterial peritonitis (14.7%), urinary tract infections (14.7%), acute hepatitis A in 2%, and acute hepatitis E in 1.2% of patients.High mortality was found to be significantly linked with hepatic encephalopathy, inadequate salt, and a high International Normalised Ratio (INR).Conclusion: ACLF is distinguished by rapid deterioration, especially when multiorgan failure develops as a result of specific triggering circumstances in a previously recognised or unknown chronic liver ailment.