Abstract

ntroduction and Objectives:Acute-on-chronic liver failure(ACLF) is characterized by acute decompensation of liver cirrhosisassociated with extrahepatic organ failure, and high short-termmortality. Previous studies have estimated a global prevalence of35% with a mortality of up to 58% at 90 days of follow-up. Thereis sparse data of ACLF prevalence and mortality in Latin Americausing the European Association for the Study of Chronic LiverFailure (EASL-CLIF) criteria. This study aimed to characterizepatients with ACLF in Latin America and estimate its prevalenceand mortality.Materials and Methods:Pubmed from 01/03/2013 to 08/02/2023was searched for Latin American cohort studies on ACLF, using theEASL-CLIF criteria. With the data obtained the meta-analysis wasperformed.Results:Six studies were included in the analysis, with a total of817 patients hospitalized for decompensated cirrhosis. The mean fol-low-up time was 69.9§31.5 days. ACLF prevalence was 29.3%, where81.5% of these patients had presented previous decompensation. Thetwo-most common liver disease etiologies were alcohol-related liverdisease (43.1%), and viral hepatitis (36.5%). The most common trig-gers identified were infections (35.8%), and gastrointestinal bleeding(22.9%). In up to 28% of the cases, the trigger remained unknown. Themain organ disfunctions were renal failure (51.2%), and circulatoryfailure (45.9%). Overall ACLF mortality was 74.0%, with up to 84.4% inpatients classified as ACLF 3.Conclusions:ACLF is a global important health-care problemincluding in Latin American. The prevalence of ACLF in our study issimilar to the prevalence reported worldwide, but in this region,there is a higher mortality. Our results emphasize the importance ofcreating local management guidelines for patients with ACLF in LatinAmerica.