Serum ferritin concentration predicts mortality in patients with hepatitis B virus-related acute on chronic liver failure

Abstract

Background and aims: This study was designed to investigate the association between serum ferritin concentration (SF) and hepatitis B virus infected patients with acute-on-chronic liver failure (AoCLF). In addition, we analyzed whether SF levels are associated with mortality in AoCLF patients.

Methods: One hundred and seventeen patients, including 46 patients with chronic hepatitis B (CHB), 71 with AoCLF, and 55 healthy controls (HCs) were enrolled in this study. All patients were followed for 4 months. In all subjects, a blood sample was collected at admission to examine liver function, renal function, international normalized ratio, and SF levels. A total of six clinical chemistry and biochemical variables (e.g., model for end-stage liver disease [MELD] score, age, levels of SF, total protein, albumin, and alanine aminotransferase) were measured and analyzed for their association with outcomes by using Cox proportional hazards and multiple regression models.

Results: AoCLF patients had significantly higher SF levels at admission compared to HCs and CHB (all p = 0.001). Elevated SF levels were associated with increased severity of liver disease and 3-month mortality rate. Multivariate analysis demonstrated that SF levels and MELD score were independent predictors for mortality (both p <0.001).

Conclusion: The SF measured at admission may serve as an independent predictor for 3-month mortality rate in AoCLF patients.

Keywords: Acute-on-chronic liver failure (AoCLF); Serum ferritin concentration (SF); mortality.