Language

English

Publication Date

3-9-2024

Journal

Scientific Reports

DOI

10.1038/s41598-024-56401-x

PMID

38461166

PubMedCentral® Posted Date

3-9-2024

PubMedCentral® Full Text Version

Post-print

Abstract

The relationship between ammonia and liver-related complications (LRCs) in acute-on-chronic liver failure (ACLF) patients is not clearly established. This study aimed to evaluate the association between ammonia levels and LRCs in patients with ACLF. The study also evaluated the ability of ammonia in predicting mortality and progression of LRCs. The study prospectively recruited ACLF patients based on the APASL definition from the ACLF Research Consortium (AARC) from 2009 to 2019. LRCs were a composite endpoint of bacterial infection, overt hepatic encephalopathy (HE), and ascites. A total of 3871 cases were screened. Of these, 701 ACLF patients were enrolled. Patients with LRCs had significantly higher ammonia levels than those without. Ammonia was significantly higher in patients with overt HE and ascites, but not in those with bacterial infection. Multivariate analysis found that ammonia was associated with LRCs. Additionally, baseline arterial ammonia was an independent predictor of 30-day mortality, but it was not associated with the development of new LRCs within 30 days. In summary, baseline arterial ammonia levels are associated with 30-day mortality and LRCs, mainly overt HE and ascites in ACLF patients.

Keywords

Humans, Acute-On-Chronic Liver Failure, Ammonia, Ascites, Prognosis, Hepatic Encephalopathy, Bacterial Infections, Hepatology, Biological techniques, Molecular medicine, Pathogenesis

Published Open-Access

yes

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