Abstract: Objective To analyze the risk factors for poor prognosis of patients with hepatitis E-induced liver failure. Methods 140 patients with hepatitis E-induced liver failure were admitted to our hospital between March 2009 and March 2016. 63 patients survived and 77 died. The independent risk factors for poor prognosis were analyzed by univariate and multivariate Logistic analysis. Results The peak serum alpha-fetoprotein level in dead patients was（47.6±8.9） ng/ml,significantly lower than（175.8±254.1） ng/ml（P<0.05） in the survival,total serum bilirubin level was（377.3±164.6） μmol/L,much higher than （251.7±151.4） μmol/L （P<0.05） in the survival,the INR was（2.4±0.6）,much higher than[（1.6±0.2）,P<0.001] in the survival,while serum albumin level was （32.2±9.9） g/L,significantly lower than（35.8±8.2）g/L （P<0.05） in the survival;univariate analysis showed that older than 60 year （P<0.001）,with underlying liver disease （P=0.032）,complicated by hepatic encephalopathy （HE,P=0.024）,infection （P=0.03）,gastrointestinal bleeding （GIB,P=0.014） and with ascites （P=0.02） were the related factors impacting prognosis,and multivariate Logistic analysis demonstrated that HE （P=0.005）,infection （P<0.001）,GIB（P=0.001） and underlying liver disease（P=0.004） were the independent risk factors for poor prognosis of patients with hepatitis E-induced chronic-on-acute liver failure. Conclusion Some patients with hepatitis E would deteriorate to liver failure,and the chronic-on-acute are common. About fifty percent of the patients survive with conventional supporting treatment,and patients with hyperbilirubinemia and extremely elevated INR would have poor prognosis,especially in patients with underlying liver diseases and complicated by HE, infection and GIB. Clinicians should take this into consideration to deal with the patients with hepatitis E at risk carefully for improvement of prognosis.

Key words: Hepatic failure, Hepatitis E, Prognosis, Influencing factors