关键词: 脓毒症, 急性肝衰竭, 生存预后状况, 风险因素

Abstract: Objective To analyze the prognosis and risk factors of patients with acute liver failure secondary to sepsis. Methods A total of 152 patients with acute liver failure secondary to sepsis admitted to our hospital from February 2022 to March 2024 were selected as the research objects. The patients were followed up for 3 months, and were divided into survival group and death group according to whether the patients died. The clinical data of all patients [procalcitonin (PCT), serum total bilirubin (TBiL), alpha-fetoprotein (AFP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), etc.] were collected. Univariate analysis was used to analyze the related factors affecting survival prognosis, and multivariate Cox regression model was used to analyze the independent risk factors affecting survival prognosis. Results Thirty patients died within 3 months, and the mortality rate was 19.74% (30/152). Univariate analysis showed that, Hepatic encephalopathy, fungal infection, age, procalcitonin (PCT), total bilirubin (TBIL), albumin (ALB), model for end-stage liver disease (MELD), neutrophil/lymphocyte ratio (NLR), international normalized ratio (INR), platelet (PLT), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APAC) HEⅡ) score were related factors affecting the survival prognosis (χ²/t=18.527, 27.136, 10.322, 25.489, 7.212, 3.078, 11.748, 5.350, 15.763, 6.574, 9.594, 7.411, all P<0.05). Cox multivariate analysis showed that fungal infection, PCT, TBiL, age, PLT, SOFA, APACHEⅡ score were independent risk factors affecting the survival prognosis (HR=5.109, 1.881, 4.039, 3.212, 6.862, 1.992, 7.683, all P<0.05). Conclusion The prognosis of patients with acute liver failure secondary to sepsis within 3 months is poor, and PCT, TBiL, fungi, PLT, age, SOFA, APACHEⅡ score are independent risk factors affecting the survival prognosis.

Key words: Sepsis, Acute liver failure, Survival and prognosis status, Risk Factors