Analysis Of Factors Influencing Survival Time Of Patients With Liver Failure Treated With Artificial Liver

Objective:By grouping patients with artificial liver treatment times,the timing of artificial liver treatment intervention(prothrombin time activity,total bilirubin,albumin)and age,to compare the differences in survival time among different groups,and discusse the effects of the above factors on the survival time of patients with liver failure after artificial liver treatment.Methods:Clinical data of patients diagnosed with liver failure and treated with artificial liver therapy were collected from infectious diseases Department of our hospital from January2019 to March 2022.X-tile software was used to divide the patients into four groups according to the frequency of artificial liver treatments(1 time group,2-4 times groups,5times groups,≥ 6 times groups).The related laboratory indexes(alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB),prothrombin time activity(PTA))and survival time(all patients were followed up from the day of admission)were compared before artificial liver treatment in each group.Using X-tile software,the patients were divided into three groups according to PTA(≤21%,21-30%,≥30%),divided into three groups according to TBIL(≤300umol/L,300-550umol/L,≥550umol/L),divided into three groups according to ALB(≤25g/L,25-35g/L,≥35g/L),and divided into three groups according to age(≤45years old,46-54 years old,≥55 years old).To compare the survival time of patients in each group,and to investigate the effects of the frequency of artificial liver therapy,PTA,TBIL,ALB and age on the survival time of patients with liver failure after artificial liver therapy.Results:1.General data and clinical characteristics: 102 patients were screened out strictly according to the inclusion and exclusion criteria.General data: 56 males and 46 females,patients ranged in age from 14 to 79 years old.Types of liver failure: acute liver failure in22 cases(21.57%),subacute liver failure in 17 cases(16.67%),acute-on-chronic liver failure in 49 cases(48.04%),chronic liver failure in 14 cases(13.73%);Among the causes of liver failure,39 cases(38.24%)were viral hepatitis,24 cases(23.53%)were drug-induced liver damage,16 cases(15.69%)were unexplained liver disease.Clinical symptoms: jaundice was the most common,accounting for 90.20%,followed by fatigue,anorexia,accounting for 58.82%,56.86%;Complications: ascites in 83 cases(81.37%),hypoproteinemia in 81 cases(79.41%);Survival time: 75 patients(73.53%)survived 4weeks after admission,58 patients(56.86%)survived 12 weeks,and 47 patients(47.06%)survived 24 weeks.2.The effect of the frequency of artificial liver treatments on the survival time of patients with liver failure.There were no significant differences in ALT,AST,TBIL,ALB and PTA before treatment among different times of artificial liver treatment groups(P > 0.05),the baseline was the same in all groups.The 24-week survival rate was the lowest in the 6-9 times treatment group,and the highest in the 5 times treatment group,with statistical significance(P < 0.05).3.The effect of artificial liver intervention timing on the survival time of patients with liver failure.Effects of PTA on survival time of patients with liver failure: the24-week survival rate of patients in PTA≥30% group was the highest,and the survival rate of patients in PTA≤21% group was the lowest,the difference was statistically significant(P < 0.05).Effects of TBIL on survival time of patients with liver failure:,the24-week survival rate of patients in the TBIL≤300umol/L group was the highest,while the 24-week survival rate of patients in the TBIL≥550umol/L group was the lowest,with statistical significance(P < 0.05).Effect of ALB on survival time of patients with liver failure: there was no significant difference in survival rate among the three groups(P > 0.05).4.The influence of age on survival time of patients with liver failure.The 24-week survival rate in 46-54 years old group was the lowest,while the 24-week survival rate in14-45 years old group was the highest,with statistical significance(P < 0.05).Conclusions:1.Acute-on-chronic liver failure is the most common clinical type in patients with liver failure treated with artificial liver.The main cause of liver failure is viral hepatitis.The mortality rate of patients with liver failure was the highest within 4 weeks,it can be paid more attention in clinical practice.2.The frequency of artificial liver treatment had a significant impact on the survival time of patients with liver failure.The 24-week survival rate of patients with liver failure who received multiple artificial liver treatments was higher than that of those who received single treatment,but the survival rate of patients who received more than 6artificial liver treatments was lower.It is suggested that patients who underwent more than 6 times of artificial liver treatment have lower efficacy and cost-effectiveness.3.The timing of artificial liver intervention has a significant effect on the survival time of patients with liver failure,PTA,TBIL and age are significantly related to the survival time of patients with liver failure.The lower the PTA and the higher the TBIL,the lower the survival time of patients with liver failure.