Clinical and Laboratory Characteristics and Mortality in Patients with Liver Cirrhosis
B. M. Taraki,
I. G. Adamova,
L. Yu. Ilchenko,
I. G. Fedorov,
G. G. Totolyan,
N. V. Petrenko,
I. G. Nikitin https://doi.org/10.20514/2226-6704-2026-16-1-38-48
EDN: QOZDCN
Abstract
Background: To present clinical and laboratory characteristics and assess 28-day mortality in patients with liver cirrhosis (LC).
Materials and Methods: The study included 137 patients (mean age 51±11; 75 (54,7 %) males) with LC. The diagnosis was established based on clinical, laboratory, and instrumental data. According to the CLIF-C OF organ dysfunction score, patients were divided into two groups: the main group (n=72, mean age 52±11; 37 (51,4 %) males) — with acute-on-chronic liver failure (ACLF), and the comparison group (n=65, mean age 49±11; 38 (58,5 %) males) — with decompensated liver cirrhosis (DC) without ACLF. Clinical parameters, inflammatory markers, ammonia and lactate levels, prognostic scores, and 28-day mortality were assessed. Statistical analysis was performed using IBM SPSS 26.
Results: Among patients with LC, 72 (52,6 %) had DC and 65 (47,4 %) had ACLF. Alcoholrelated etiology was predominant (52,8 % and 63,1 %, respectively). Patients with ACLF were characterized by significantly more severe hepatic and renal dysfunction, systemic inflammation, and higher scores on all prognostic scales (p <0,001). The 28-day mortality rate was 9,7 % in the DC group and 27,7 % in the ACLF group, reaching 71,4 % for ACLF grade 3. Survival analysis showed significant differences between the groups (Log-Rank p <0,001).
Conclusion: A high prevalence of ACLF was established among hospitalized patients with LC. The use of the CLIF-C OFs scale allows for effective risk stratification of patients, which is important for determining management tactics and timely referral to specialized centers.
About the Authors
B. M. Taraki
Department of Hospital Therapy named after Academician G.I. Storozhakov Medical Faculty N.I. Pirogov Russian national research medical university
Russian Federation
Competing Interests:
Russian Federation
Breshna M. Taraki — Postgraduate Student; Gastroenterologist
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
I. G. Adamova
Department of Hospital Therapy named after Academician G.I. Storozhakov Medical Faculty N.I. Pirogov Russian national research medical university
Russian Federation
Competing Interests:
Russian Federation
Imara G. Adamova — Postgraduate Student; Gastroenterologist
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
L. Yu. Ilchenko
Department of Hospital Therapy named after Academician G.I. Storozhakov Medical Faculty N.I. Pirogov Russian national research medical university
Russian Federation
Competing Interests:
Russian Federation
Lyudmila Yu. Ilchenko — MD, PhD, Professor
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
I. G. Fedorov
Department of Hospital Therapy named after Academician G.I. Storozhakov Medical Faculty N.I. Pirogov Russian national research medical university ; State Clinical hospital named after V.M. Buyanov
Russian Federation
Competing Interests:
Russian Federation
Ilya G. Fedorov — PhD, Associate Professor; Head of the Gastroenterology Department
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
G. G. Totolyan
Department of Hospital Therapy named after Academician G.I. Storozhakov Medical Faculty N.I. Pirogov Russian national research medical university
Russian Federation
Competing Interests:
Russian Federation
Gayane G. Totolyan — PhD, Associate Professor; Gastroenterologist
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
N. V. Petrenko
State Clinical hospital named after V.M. Buyanov
Russian Federation
Competing Interests:
Russian Federation
Natalia V. Petrenko — Head of the Pathological Anatomy Department
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
I. G. Nikitin
Department of Hospital Therapy named after Academician G.I. Storozhakov Medical Faculty N.I. Pirogov Russian national research medical university
Russian Federation
Competing Interests:
Russian Federation
Igor G. Nikitin — MD, PhD, Professor, Head of the Department
Moscow
Competing Interests:
Co-author of the article Nikitin I.G. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article has passed the peer-review procedure adopted by the journal. Nikitin I.G. did not participate in the decision to publish this article. Co-author of the article Ilchenko L.Yu. is the editor-in-chief of the journal «The Russian Archives of Internal Medicine». The article has passed the peerreview procedure adopted by the journal. The decision to publish the article was made by the editorial board without the participation of the editor-in-chief. The authors did not declare any other conflicts of interest
References
1. Sepanlou S.G., Safiri S., Bisignano C. et al. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5(3):245-266. doi: 10.1016/S2468-1253(19)30349-8.
2. Devarbhavi H., Asrani S.K., Arab J.P. et al. Global burden of liver disease: 2023 update. J Hepatol. 2023;79(2):516-537. doi: 10.1016/j.jhep.2023.03.017.
3. Artru F., Reiberger T. One — or more — blind spot(s) unveiled in the new definition of decompensated cirrhosis. J Hepatol. 2024;80(4):537-539. doi: 10.1016/j.jhep.2024.01.039.
4. Arroyo V., Angeli P., Moreau R. et al. The systemic inflammation hypothesis: towards a new paradigm of acute decompensation and multiorgan failure in cirrhosis. J Hepatol. 2021;74(3):670–685. doi: 10.1016/j.jhep.2020.11.048.
5. Trebicka J., Hernaez R., Shawcross D.L. et al. Recent advances in the prevention and treatment of decompensated cirrhosis and acuteon-chronic liver failure (ACLF) and the role of biomarkers. Gut. 2024;73(6):1015-1024. doi: 10.1136/gutjnl-2023-330584.
6. D’Amico G., Bernardi M., Angeli P. Towards a new definition of decompensated cirrhosis. J Hepatol. 2022;76(1):202-207. doi: 10.1016/j.jhep.2021.06.018.
7. Moreau R., Jalan R., Gines P. et al. CANONIC Study Investigators of the EASL–CLIF Consortium. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology. 2013;144(7):1426-1437. doi: 10.1053/j.gastro.2013.02.042.
8. Mezzano G., Juanola A., Cardenas A. et al. Global burden of disease: acute-on-chronic liver failure, a systematic review and meta-analysis. Gut. 2022;71(1):148-155. doi: 10.1136/gutjnl-2020-321161.
9. Ivashkin V.T., Maevskaya M.V., Zharkova M.S. et al. Clinical guidelines of the Russian Society for the Study of the Liver and the Russian Gastroenterological Association for the diagnosis and treatment of liver fibrosis and cirrhosis and their complications. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(6):56-102. [In Russian].
10. Pugh R.N., Murray-Lyon I.M., Dawson J.L. et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646-649. doi: 10.1002/bjs.1800600817.
11. Wiesner R., Edwards E., Freeman R. et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124(1):91–96. doi: 10.1053/gast.2003.50016.
12. Leise M.D., Kim W.R., Kremers W.K. et al. A revised model for end-stage liver disease optimizes prediction of mortality among patients awaiting liver transplantation. Gastroenterology. 2011;140(7):1952-1960. doi: 10.1053/j.gastro.2011.02.017.
13. Maddrey W.C., Boitnott J.K., Bedine M.S. , et al. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978;75(2):193-199. PMID: 352788.
14. Vincent J.L., Moreno R., Takala J. et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707–710. doi: 10.1007/BF01709751.
15. Jalan R., Saliba F., Pavesi M. et al. Development and validation of a prognostic score to predict mortality in patients with acute-onchronic liver failure. J Hepatol. 2014;61(5):1038-1047. doi: 10.1016/j.jhep.2014.06.012.
16. Li D., Sun W., Chen L. et al. Utility of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in predicting acute-on-chronic liver failure survival. Open Life Sci. 2023;18(1): 20220644. doi: 10.1515/biol-2022-0644.
17. Lazebnik L.B., Golovanova E.V., Alekseenko S.A. et al. Russian consensus “Hyperammonemia in adults” (Version 2021). Eksperimental’naya i Klinicheskaya Gastroenterologiya. 2021;187(3):97-118. doi: 10.31146/1682-8658-ecg-187-3-97-118. [In Russian].
18. Amonker S., Houshmand A., Hinkson A. et al. Prevalence of alcohol-associated liver disease: A systematic review and meta-analysis. Hepatol Commun. 2023;7(5):e0133. doi: 10.1097/HC9.0000000000000133.
19. Ritchie H, Roser M. Alcohol Consumption. Our World in Data. 2022. Available from: https://ourworldindata.org/alcohol-consumption. [Online Resource]
20. Laleman W., Claria J., Van der Merwe S. et al. Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough. Can J Gastroenterol Hepatol. 2018;2018:1027152. doi: 10.1155/2018/1027152.
21. Pandey S., Kawai T., Akira S. Microbial sensing by Toll-like receptors and intracellular nucleic acid sensors. Cold Spring Harb Perspect Biol. 2014;7(1):a016246. doi: 10.1101/cshperspect.a016246.
22. González-Navajas J.M. Inflammasome activation in decompensated liver cirrhosis. World J Hepatol. 2016;8(4):207-210. doi: 10.4254/wjh.v8.i4.207.
23. Chiriac S., Stanciu C., Singeap A.M. et al. Prognostic value of neutrophil-to-lymphocyte ratio in cirrhotic patients with acuteon-chronic liver failure. Turk J Gastroenterol. 2020;31(12):868-876. doi: 10.5152/tjg.2020.19838.
24. Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy. 2021;122(7):474-488. doi: 10.4149/BLL_2021_078.
25. Hernaez R., Solà E., Moreau R. et al. Acute-on-chronic liver failure: an update. Gut. 2017;66(3):541-553. doi: 10.1136/gutjnl-2016-312670.
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For citations:
Taraki B.M., Adamova I.G., Ilchenko L.Yu., Fedorov I.G., Totolyan G.G., Petrenko N.V., Nikitin I.G. Clinical and Laboratory Characteristics and Mortality in Patients with Liver Cirrhosis. The Russian Archives of Internal Medicine. 2026;16(1):38-48. https://doi.org/10.20514/2226-6704-2026-16-1-38-48. EDN: QOZDCN
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