REAL-LIFE PERCEPTION OF ACLF IN ROMANIA: RESULTS OF A SURVEY COMPLETED BY PRACTICIANS

Abstract

Acute-on-chronic liver failure (ACLF) is a relatively new concept introduced in order to better assess the risk of death in patients with acute decompensation of chronic liver disease. The diagnostic criteria are currently still under debate, but the most recent definition is based on the presence of acute decompensation of cirrhosis associated with organ failure according to the CLIF Consortium ACLF score (CLIF-C ACLF score). Aim: To establish the real-life perception of ACLF among Romanian practitioners. Material and methods: We assessed current diagnosis patterns for ACLF, and we developed a dichotomous question survey concerning the current knowledge on ACLF. The survey was sent by e-mail to the members of the Romanian Society of Gastroenterology and Hepatology (SRGH); a printed survey was completed by intensive care practitioners from “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania. We evaluated the specialty of the practitioners included, the professional degree, and the participant’s clinical and diagnostic abilities concerning the assessment of ACLF. Results: 263 practitioners responded to the survey: 69% gastroenterologists, 22% internal medicine consultants and 9% intensive care specialists; 31% of responders were trainees, 35% consultants and 34% senior consultants, most of them working in a university hospital (66%). The majority of the participants had heard of ACLF (94%). 73% of responders considered that there were unanimously accepted criteria for the diagnosis of ACLF. Almost all responders (98%) considered the liver to be the most common organ failure in ACLF patients. Most participants agreed that the younger and alcoholic patients had a higher risk for developing ACLF (84%) and that ascites degree was not relevant for the diagnosis (65%). Conclusions: The results show that knowledge of the diagnosis and characteristics of ACLF among practitioners in Romania are according with the current ACLF published criteria. However, the percent of practitioners that applied the ACLF criteria in clinical practice was not determined and could represent a subject for future research.