Rao Saad Shadab, Muhammad Shoaib Khan, Farrukh Saeed, Syed Kumail Hasan Kazmi, Fuad Ahmed Siddiqi, Rafi-ud Din.
Acute-on-chronic liver failure-outcome and its predictors in a tertiary care hospital.
Pak Armed Forces Med J Jan ;72(1):190-93.

Objective: To determine the characteristics and outcome of acute-on-chronic liver failure patients being managed at Pak Emirates Military Hospital Rawalpindi. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology at Pak-Emirates Military Hospital, Rawalpindi, from Sep 2018 to Jan 2021. Methodology: In this study, 1559 patients diagnosed with cirrhosis were studied. Patients with pre-existing chronic kidney disease, chronic obstructive pulmonary disease, cardiac failure, dementia, and stroke were excluded. All the relevant features of each case were recorded in the proforma. Results: Out of 1559 patients, 67 had Acute-on-chronic liver failure. The majority of patients who presented with acute-onchronic liver failure were in grade Ib (55%), followed by grade II (30%). Hepatitis C virus related liver cirrhosis was the commonest underlying liver disease (78.4%). Drugs were the commonest triggering factor (33%), followed by acute viral hepatitis (27%). However, a large number of patients had no identifiable cause (25.4%). Conclusion: Acute-chronic-liver failure is common in patients presenting with acute decompensation of liver cirrhosis. Patients undergoing liver transplantation in the correct window period, have good prognosis.

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