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Comparative Study
. 2025 Sep 3;25(1):637.
doi: 10.1186/s12876-025-04234-x.

Acute versus acute-on-chronic liver failure: comparative analysis of clinical outcomes in Beijing, China

Hebing Guo  1 , Ningning Yin  1 , Jingyuan Liu  2 , Ang Li  3
Affiliations
Comparative Study

Acute versus acute-on-chronic liver failure: comparative analysis of clinical outcomes in Beijing, China

Hebing Guo et al. BMC Gastroenterol. .

Abstract

Background: Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) pose significant threats to patient outcomes, frequently resulting in multiple organ dysfunction syndrome (MODS) and elevated mortality rates. This study investigates MODS outcomes among ALF and ACLF patients in China, identifying key factors that influence mortality and prognosis.

Methods: A retrospective cohort analysis was conducted at a specialized tertiary hospital in Beijing, covering the period from June 2009 to May 2022, which included 585 patients:195 with ALF and 390 with ACLF.

Results: Among these, 61% of ALF patients and 45.1% of ACLF patients developed MODS. ALF patients exhibited a higher incidence of organ failures and significantly higher median admission critical illness scores. Multivariate logistic regression analysis identified age, number of organ failures, and platelet count as independent predictors of 90-day mortality. Kaplan-Meier survival hazards analysis revealed significantly higher 90-day cumulative mortality rates for ALF patients compared to ACLF patients (33.8% vs. 25.9%, p = 0.009).

Conclusion: Approximately 50% of liver failure patients progress to MODS, with ALF patients demonstrating a higher incidence of MODS and poorer 90-day prognoses.

Keywords: Acute liver failure; Acute-on-chronic liver failure; Clinical outcomes; Cohort study; Multiple organ dysfunction syndrome.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study adhered to the ethical standards outlined in the “Declaration of Helsinki” and the “Ethical Review of Biomedical Research Involving Humans”. The research involved no interference with diagnosis or treatment; it utilized only observational data for analysis. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The Kaplan-Meier survival curves for 90-day survival in the ACLF and ALF groups
Fig. 2
Fig. 2
The effectiveness logistics, MELDNA score, ClifSOFA score in predicting the 90-day mortality in patients with ACLF
Fig. 3
Fig. 3
The effectiveness of logistics, MELD score, SOFA score in predicting the 90- day mortality in patients with ALF
See this image and copyright information in PMC

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