Value of serum tryptophan in stratified management of 90-day mortality risk in patients with hepatitis B virus-related acute-on-chronic liver failure:a multicenter retrospective study
ZHOU Chao
ZHANG Jingjing
TANG Qiao
FU Shuangnan
ZHANG Ning
HE Zhaoyun
ZHANG Jin
ZHANG Tianyi
LIU Pengcheng
GONG Man
Abstract：Objective To explore the correlation of serum tryptophan level with 90-day mortality risk in patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods This retrospective study was conducted among 108 patients with HBV-ACLF,whose survival outcomes within 90 days after diagnosis were recorded.The correlation of baseline serum tryptophan levels measured by high-performance liquid chromatography with 90-day mortality of the patients was analyzed,and the predictive value of serum tryptophan for 90-day mortality was explored.Results Within 90 days after diagnosis,53(29.4％)of the patients died and 127(70.6％)survived.The deceased patients had significantly lower baseline serum tryptophan levels than the survivors(7.31±3.73 pg/mL vs 13.32±7.15 pg/mL,P＜0.001).Multivariate analysis suggested that serum tryptophan level was an independent factor correlated with mortality of HBV-ACLF after adjustment for confounding variables.The patients with serum tryptophan levels below the median level(10.14 pg/mL)at admission had significantly higher 90-day mortality risks than those with higher tryptophan levels(43.3％vs 15.6％,HR:3.157,95％CI:1.713-5.817),and the complication by kidney dysfunction further increased the risk to 73.3％as compared with patients with higher serum tryptophan levels with normal kidney function(15.0％;HR:7.558,95％CI:3.369-16.960).Serum tryptophan levels had an area under the receiver operating characteristic curve of 0.771(95％CI:0.699-0.844)for predicting 90-day mortality.Conclusion Serum tryptophan level is closely correlated with the survival outcomes of patients with HBV-ACLF,and a decreased tryptophan level indicates a high 90-day mortality risk,which can be further increased by the complication by kidney dysfunction.
Keywords：liver failureprognosistryptophanhepatitis B viruskidney dysfunction
Publication Date：2025-01-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 59-64 )