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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Hepatic Encephalopathy | Research

Risk factors for the mortality of hepatitis B virus-associated acute-on-chronic liver failure: a systematic review and meta-analysis

Authors: Hanyun Tu, Rong Liu, Anni Zhang, Sufei Yang, Chengjiang Liu

Published in: BMC Gastroenterology | Issue 1/2023

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Abstract

Background

Hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) has been confirmed as a prevalent form of end-stage liver disease in people subjected to chronic HBV infection. However, there has been rare in-depth research on the risk factors for the mortality of HBV-ACLF. This study aimed at determining the risk factors for the mortality of HBV-ACLF.

Methods

The relevant research was selected from four electronic databases that have been published as of August 2023. The existing research was reviewed in accordance with the inclusion and exclusion criteria. The level of quality of previous research was evaluated using the Newcastle–Ottawa scale. Moreover, a pooled estimate of the odds ratios (ORs) with their associated 95% confidence intervals (CIs) was provided through a meta-analysis. The data were combined, and the risk variables that at least two studies had considered were analyzed. The publication bias was examined through Egger's test and Begg's test.

Results

Twenty two studies that conformed to the inclusion criteria were selected from 560 trials. Eight risk variables in terms of HBV-ACLF mortality were determined, which covered INR (OR = 1.923, 95% CI = 1.664–2.221, P < 0.001), Monocytes (OR = 1.201, 95% CI = 1.113–1.296, P < 0.001), Cirrhosis (OR = 1.432, 95% CI = 1.210–1.696, P < 0.001), HE (OR = 2.553, 95% CI = 1.968–3.312, P < 0.001), HE grade (OR = 2.059, 95% CI = 1.561–2.717, P < 0.001), SBP (OR = 1.383, 95% CI = 1.080–1.769, P = 0.010), Hyponatremia (OR = 1.941, 95% CI = 1.614–2.334, P < 0.001), as well as HRS (OR = 2.610, 95% CI = 1.669–4.080, P < 0.001).

Conclusion

The most significant risk factors for HBV-ACLF mortality comprise HRS, HE, and HE grade, followed by INR and hyponatremia. The Monocytes, cirrhosis, and SBP have been confirmed as the additional key risk factors for HBV-ACLF mortality.
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Metadata
Title
Risk factors for the mortality of hepatitis B virus-associated acute-on-chronic liver failure: a systematic review and meta-analysis
Authors
Hanyun Tu
Rong Liu
Anni Zhang
Sufei Yang
Chengjiang Liu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02980-4

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