急性至慢性肝衰竭的定义,病因和结果:系统性审查和元分析
Arnav Aggarwal1, Sagnik Biswas1, Umang Arora1
1Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Delhi, India.
概括
急性至慢性肝衰竭 (ACLF) 的定义在全球范围内有所不同,影响患者的治疗结果和临床表现. 为了更好地解释和研究ACLF中的数据,需要一个标准化的定义.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
- 临床研究 临床研究
背景情况:
- 急性至慢性肝衰竭 (ACLF) 是一个重大的全球健康挑战.
- 在ACLF定义的变化使研究和临床管理复杂化.
研究的目的:
- 分析ACLF定义的全球格局.
- 评估病因谱,器官衰竭模式和与不同ACLF分类相关的结果.
主要方法:
- 对1990年至2022年9月期间发表的关于ACLF的研究进行了全面的元分析.
- 提取了关于定义,沉物,潜在肝病,器官衰竭和死亡率的数据.
- 用随机效应模型对每个ACLF定义进行聚合的流行率.
主要成果:
- 包括114篇文章 (142个队列,210239名患者),主要使用EASL和APASL定义.
- 系统性感染和酒精使用是慢性肝病的关键原因和原因,根据定义有所不同.
- 对于EASL定义的ACLF,三十天死亡率在各定义之间有显著差异 (APASL: 38.9%,EASL: 47.9%,NACSELD: 52.2%),受世卫组织地区的影响.
结论:
- 在ACLF定义中的异质性导致不同的临床表型和结果.
- 区域偏好和不同的专家协会建议有助于这种变化.
- 统一的ACLF定义对于改善全球数据的可比性和解释性至关重要.
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