Abstract: Objective To explore the risk factors that affect the survival of chronic hepatitis B (CHB) patients complicated with liver failure. Methods The clinical data of 140 CHB patients complicated with liver failure were retrospectively analyzed. The patients were divided into a survival group (clinical symptoms improved after treatment, n=77) and a death group (death after treatment, n=63) according to whether they survived after comprehensive medical treatment. The clinical data of these two groups of patients were compared. Single and multivariate logistic regression analyses were used to identify the risk factors that affect the survival of CHB patients complicated with liver failure. Results The result of univariate analysis showed that the course of disease, blood ammonia level, CTP score, MELD score, blood sodium level, age, alkaline phosphatase level, transaminase level, serum bilirubin level, prothrombin time, the occurrence of encephalopathy, hepatorenal syndrome, and gastrointestinal hemorrhage were the factors that impact on the survival of CHB patients with liver failure (all P<0.05). Further multi-variate analysis showed that advanced age, high levels of alkaline phosphatase, transaminase, serum bilirubin, prolonged prothrombin time, the occurrences of hepatic encephalopathy, hepatorenal syndrome, and gastrointestinal hemorrhage are independent risk factors for the survival of CHB patients with liver failure (OR=1.347, 1.029, 1.654, 1.352, 1.274, 0.081, 16.415, 0.937, respectively,all P<0.05). Conclusion Old age, high levels of alkaline phosphatase, transaminase, serum total bilirubin, and prolonged prothrombin time, the occurrences of hepatic encephalopathy, hepatorenal syndrome, and gastrointestinal hemorrhage are risk factors that impact on the survival of CHB patients with liver failure.

Key words: Chronic hepatitis B, Liver failure, Death, Prognosis, Risk factors