Acute on Chronic Liver Failure Clinical Trial
Official title:
A Prospective Evaluation of the Role of Transient Elastography (Fibroscan) in Differentiating Patients of Acute Severe Viral Hepatitis and Acute on Chronic Liver Failure
Transient elastography is novel non-invasive method for assessment of hepatic fibrosis in
patients with chronic liver disease, by measuring liver stiffness. Transient elastography is
a user friendly technique that can be easily performed at bedside or in outpatient clinic
with immediate results and good reproducibility.
Liver stiffness values ranges from 2.5 to 75 kPa with lower values <6kPa suggest no fibrosis
where as higher values above 14kPa suggests cirrhosis. In the present study the
investigators hypothesis that the investigators can differentiate ACLF and acute severe
viral hepatitis based on fibroscan as patients with underlying fibrosis with superadded
inflammation would have higher fibroscan value than when patient have only inflammation with
no underlying fibrosis and hence the investigators can avoid unnecessary test in such
subgroup.
Transient elastography is a novel non-invasive method that for the assessment of hepatic
fibrosis in patients with chronic liver diseases, by measuring liver stiffness.
Acute on chronic liver failure: acute hepatic insult manifesting as jaundice and
coagulopathy, complicated within 4 weeks by ascites and/or encephalopathy in patients with
previously diagnosed or undiagnosed chronic liver disease.
Acute severe hepatitis: Acute severe hepatitis which is characterized by serum bilirubin >
or = 10.0 mg/dL and international normalized ratio (INR) > or = 1.5.
Patients with acute severe viral hepatitis or acute on chronic liver failure will be
enrolled in this prospective study after taking informed written consent. All patients will
be evaluated at baseline as per standard protocol which include evaluation of etiology of
disease and tests to exclude underlying liver disease which includes ultrasound/computed
tomography and if necessary upper gastrointestinal endoscopy and liver biopsy if imaging
shows any signs of underlying liver disease. the patients will be followed up for 1 month,
all patients will undergo Fibroscan at the time of admission and thereafter at 1week and 4th
week .
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Observational Model: Case Control, Time Perspective: Prospective
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