Epidemiological analysis of acute-on-chronic liver failure in Nantong,Jiangsu Province, 2005-2014

Objective To investigate the incidence rate and short-term mortality rate of acute-on-chronic liver failure (ACLF) in Nantong, Jiangsu Province. Methods The data of newly diagnosed ACLF cases from six public hospitals in Nantong city between January 1, 2005 and December 31, 2014 were collected. The diagnosis was made according to the criteria suggested by Chinese Society for Hepatology (CSH). The sex-age structure, annual incidence rate, constituent ratio of primary disease, the causes of exacerbation and death were analyzed. Results During the ten-year period, a consecutive sample of 1 934 ACLF patients was included in this study. Male to female was 3 to 1. Patients covered all age groups. Yong patients were more frequent and 56.0% of them were aged 35 to 54 years old. The overall ACLF incidence rate decreased from 3.4 per 100 000 in 2005 to 2.1 per 100 000 in 2014. The three commonest causes of ACLF were chronic hepatitis B (CHB) (91.0%), autoimmune liver diseases (AILD) (3.0%) and alcoholic liver diseases (ALD) (2.7%). The 28-day mortality rate of the ACLF patients had a decline during the study period, form 50.4% in 2005 to 35.4% in 2014.The mortality rate was remarkablely higher for those who had been diagnosed with cirrhosis compared with those who had not (697/1 189, 58.6% vs 244/745, 32.8%). Conclusions In Nantong area, ACLF is more frequent in young male patients. The annual incidence rate of ACLF is decreasing.CHB is the main cause of ACLF. The short-term mortality of ACLF is decreasing, and mortality is associated with the presence of cirrhosis and older age. Key words: Acute-on-chronic liver failure; Incidence; Etiology; Mortality