Abstract: Objective The aim of this study was to investigate the prognostic factors of patients with type B and type C acute-on-chronic liver failure(ACLF) and moderate or severe esophageal varices (EV). Methods The clinical materials in 58 patients with ACLF (type B in 18, and type C in 40) and moderate to severe EV between November 1,2017 and March 31,2020 in our hospital were retrospectively analyzed. All patients were followed-up for 6 months. The Logistic regression analysis was applied to explore the independent risk factors affecting the 6-month survival rate. Results At the end of six month followed-up, 20 patients (34.5%) died, 1 received liver transplantation, 2 lost and 35 (60.3%) survived; there were significant differences respect to ascites volume(P=0.039), esophageal vein sclerotherapy (EVS)(P=0.010), ACLF clinical types (P=0.034), different stages of hepatic encephalopathy(P=0.029) and degree of varices (P=0.046) between dead and survivals; the Logistic regression analysis showed that the ascites (OR=9.76), sclerotherapy during hospitalization (OR=19.28) and hepatic encephalopathy (OR=5.98) were the independent risk factors for 6-month survival rate. Conclusion The ACLF patients with massive ascites, severe hepatic encephalopathy and EVS treatment might have a poor short-term prognosis, and we do not recommend EVS for patients with ACLF at this setting.

Key words: Acute-on-chronic liver failure, Esophageal varices, Sclerotherapy, Risk factors, Prognosis