Secondary infections in hepatitis B patients with acute-on-chronic liver failure and its relationship with the prognosis / 中华临床感染病杂志

ABSTRACT

Objective To investigate the characteristics of secondary infections in hepatitis B patients with acute-on-chronic liver failure(ACLF)and its impact on the prognosis. Methods Infection sites, clinical and etiological characteristics were retrospectively reviewed in 186 hospitalized patients with ACLF from the Third Affiliated Hospital of Sun Yat-sen University during January to December 2007. Logistic regression was used to analyze risk factors of secondary infections. Results In 186 patients with ACLF, 160 patients(86.0%) were complicated with infections, and the common sites of infections were abdominal cavity, biliary tract, lung and intestinal tract. The rates of secondary infections were higher in patients with serum albumin(Alb)≤30 g/L, total bilirubin(TBil)>342 μmol/L, prothrombin time(PT)>28 seconds, and those complicated with one or more complications(χ~2=5.4, 7.3, 21.3 and 14.7, P<0.05). The fatality rates of patients with and without infections were 74. 5%(119/160) and 42.3%(11/26), respectively, and the difference was of statistical significance(χ~2=10.9,P=0.000). Patients with multi-organ infections had a higher fatality rate(79.8%, 79/99)than those with one organ infections(65.6%, 40/61), and the difference was also significant(χ~2=4.0, P=0.045). Conclusion Patients with ACLF are liable to infection, and the severity is closely related with the prognosis.