Analysis Of Etiology And Prognostic Factors In Aged Patients With Liver Failure

Objective:Discuss the etiology and the prognostic factors in aged patients with liver failure,provide the evidence for clinical diagnosis,treatment and disease prevention.Methods:In this retrospective study,the elderly patients(age≥65 years)with liver failure hospitalized from January 2013 to October 2019 were admitted and their medical records were reviewed to identify the etiology.Logistic regression analysis was used to investigate the risk factors affecting the prognosis in aged patients with liver failure.Results:A total of 151 aged patients with liver failure were identified in this study,age ranging from 65 to 90 years old,including 77 males(50.99%)and 74females(49.01%)。The top three causes of aged liver failure were HBV infection(41.06%,62/151),drugs(13.01%,21/151)and alcohol(11.92%,18/151).The drugs that caused liver failure in the elderly were mainly Chinese medicine(13/21,61.90%)and health products(4/21,19.05%).The deterioration rate of aged patients with liver failure was 45.70%(9/14).Among them,the deterioration rate of acute liver failure was 64.29%,59.34%in acute(subacute)-on-chronic liver failure,40.00%in subacute liver failure and 28.57%in chronic liver failure,and the differences were statistically significant(?~2=14.351,P=0.02).There were statistically significant differences between each type of liver failure in the ALF and CLF groups,(S)ACLF and CLF groups(P<0.05).The main complications were ion disorders(129/151),infection(103/151),and hepatic encephalopathy(51/151).After univariate analysis,AST,TBil,NLR,PT,ALB,PAlb,TC,PTA,hepatic encephalopathy,upper gastrointestinal bleeding,hepatorenal syndrome,infection and artificial liver support system were related to the prognosis in elderly patients with liver failure,and the differences were statistically significant(P<0.05).By logistic regression analysis,TBil,HE and UGH were risk factors for the prognosis.If ALB<27.75g/L,PTA<36.5%,TC<2.465 mmol/L,TBil>65.25 umol/L,the prognosis became worse.Conclusions:HBV infection was still the main cause of aged patients with liver failure,then drug and alcohol.The risk factors affecting the prognosis of aged patients with liver failure were hyperbilirubinemia,hepatic encephalopathy and upper gastrointestinal bleeding.If ALB<27.75g/L,PTA<36.5%,TC<2.465 mmol/L,TBil>65.25 umol/L,the prognosis became worse.