Acute Liver Failure
| Autor: | María Rosa del Fresno-Valencia, Marcello Bellusci, Javier Manzanares, Pedro Urruzuno, Enrique Medina, Soledad Montoro, Raquel Núñez-Ramos, Marta Germán-Díaz |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Encephalopathy Autoimmune hepatitis Severity of Illness Index End Stage Liver Disease 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine Severity of illness medicine Humans 030212 general & internal medicine Child Survival rate Retrospective Studies business.industry Infant Newborn Infant Retrospective cohort study General Medicine Liver Failure Acute Prognosis medicine.disease Liver Transplantation 3. Good health Surgery Survival Rate Child Preschool Pediatrics Perinatology and Child Health Emergency Medicine Etiology Female 030211 gastroenterology & hepatology Viral hepatitis business |
| Zdroj: | Pediatric Emergency Care. 34:409-412 |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0000000000000884 |
| Popis: | The aims of this study were to analyze the characteristics of patients with acute liver failure (ALF) in our center and evaluate the prognostic value of the Pediatric End-Stage Liver Disease (PELD) score calculated at admission. A retrospective analysis of patients with ALF younger than 15 years between 2005 and 2013 was performed. Information collected included age, sex, etiology of ALF, laboratory tests, PELD score, stage of encephalopathy, and need for liver support devices such as MARS and/or liver transplant (LT) and survival. A poor prognosis was defined as the need for LT or death. Twenty patients (10 male patients, 50%) with a median age of 2.6 years (3 days-14.5 y old) were included. Acute liver failure was of indeterminate cause in 5 cases (25%). Within the recognized causes, the most frequent were viral hepatitis (herpes simplex virus, adenovirus, influenza B, Epstein-Barr virus), autoimmune hepatitis, and metabolopathies. Sixty percent presented with encephalopathy at diagnosis. Four patients were aided by a MARS liver support device. Six patients received a total of 7 transplants, all from deceased donors. The rate of spontaneous recovery was 45%. Currently 13 patients (65%) are living, 4 of them with an LT. Six patients died because of ALF. The mean PELD score of patients with spontaneous recovery was 15.31 (5.3–27.6) compared with a mean of 29.5 (17.2–39.4) in LT patients and 31.55 (15.8–52.4) for nonsurvivors (P = 0.013). High PELD scores at diagnosis were accurate predictors of a poor prognosis in our patients with ALF. This model may help in the clinical management of this entity, although prospective validation is needed. |
| Databáze: | OpenAIRE |
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