Prognostic factors in paediatric acute liver failure
Objectives:To study the aetiology, outcome and prognostic indicators in children with acute liver failure (ALF).Study design:Retrospective chart review of 210 patients (107 males/103 females; median age: 5.33 years, range: 1–17.4). Patients were followed until discharge (group 1), death (group 2) or...
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| Veröffentlicht in: | Archives of disease in childhood 2008-01, Vol.93 (1), p.48-51 |
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| creator | Ciocca, M Ramonet, M Cuarterolo, M López, S Cernadas, C Álvarez, F |
| description | Objectives:To study the aetiology, outcome and prognostic indicators in children with acute liver failure (ALF).Study design:Retrospective chart review of 210 patients (107 males/103 females; median age: 5.33 years, range: 1–17.4). Patients were followed until discharge (group 1), death (group 2) or liver transplantation (LT; group 3). Data from group 1 were compared to data from the other two groups and King’s College criteria were also assessed.Results:Final diagnoses were: 128 (61%) hepatitis A, 68 (32%) indeterminate and 14 (7%) others. The characteristics of patients who survived (n = 59), died (n = 61) and underwent LT (n = 90) were analysed. In multivariate analysis, prothrombin time and encephalopathy III/IV were the most significant parameters suggesting a high likelihood of death. When King’s College criteria were applied on admission in patients with and without transplantation, the positive predictive values were 96% and 95%, and the negative predictive values were 82% and 82%, respectively.Conclusions:Hepatitis A is the main cause of ALF in children in Argentina. Advanced encephalopathy and prolonged prothrombin time were significantly associated with death or need for LT. King’s College criteria for predicting the outcome of ALF are applicable in children, including those with ALF due to hepatitis A infection. |
| doi_str_mv | 10.1136/adc.2006.115113 |
| format | Article |
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Patients were followed until discharge (group 1), death (group 2) or liver transplantation (LT; group 3). Data from group 1 were compared to data from the other two groups and King’s College criteria were also assessed.Results:Final diagnoses were: 128 (61%) hepatitis A, 68 (32%) indeterminate and 14 (7%) others. The characteristics of patients who survived (n = 59), died (n = 61) and underwent LT (n = 90) were analysed. In multivariate analysis, prothrombin time and encephalopathy III/IV were the most significant parameters suggesting a high likelihood of death. When King’s College criteria were applied on admission in patients with and without transplantation, the positive predictive values were 96% and 95%, and the negative predictive values were 82% and 82%, respectively.Conclusions:Hepatitis A is the main cause of ALF in children in Argentina. Advanced encephalopathy and prolonged prothrombin time were significantly associated with death or need for LT. King’s College criteria for predicting the outcome of ALF are applicable in children, including those with ALF due to hepatitis A infection.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/adc.2006.115113</identifier><identifier>PMID: 17872939</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Adolescent ; Antibodies ; Antigens ; Argentina - epidemiology ; Attrition (Research Studies) ; Bilirubin - blood ; Biological and medical sciences ; Care and treatment ; Child ; Child, Preschool ; Children ; Disease ; Diseases ; Epstein-Barr virus ; Etiology ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Hepatic Encephalopathy - classification ; Hepatic Encephalopathy - mortality ; Hepatitis ; Hepatitis A ; Hepatitis A - complications ; Hepatitis B ; Hospitals ; Humans ; Infant ; International Normalized Ratio ; Liver ; Liver failure ; Liver Failure, Acute - etiology ; Liver Failure, Acute - mortality ; Liver Failure, Acute - surgery ; Liver Transplantation ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical prognosis ; Medical records ; Medical sciences ; Medical Services ; Miscellaneous ; Mortality ; Multivariate Analysis ; Other diseases. Semiology ; Patients ; Pediatric diseases ; Pediatrics ; Predictive Value of Tests ; Prevention and actions ; Prognosis ; Prothrombin Time ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Records (Forms) ; Retrospective Studies ; Sepsis ; Serology ; Statistical Analysis ; Statistical Significance ; Transplants & implants ; Variance analysis</subject><ispartof>Archives of disease in childhood, 2008-01, Vol.93 (1), p.48-51</ispartof><rights>2008 BMJ Publishing Group and Royal College of Paediatrics and Child Health</rights><rights>2008 INIST-CNRS</rights><rights>Copyright: 2008 2008 BMJ Publishing Group and Royal College of Paediatrics and Child Health</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b495t-484ca7f014c94df04e7d5f9d08c77aec985942c4e25db37e55ac28a8d08af2e53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://adc.bmj.com/content/93/1/48.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://adc.bmj.com/content/93/1/48.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,4024,23571,27923,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19907406$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17872939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ciocca, M</creatorcontrib><creatorcontrib>Ramonet, M</creatorcontrib><creatorcontrib>Cuarterolo, M</creatorcontrib><creatorcontrib>López, S</creatorcontrib><creatorcontrib>Cernadas, C</creatorcontrib><creatorcontrib>Álvarez, F</creatorcontrib><title>Prognostic factors in paediatric acute liver failure</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>Objectives:To study the aetiology, outcome and prognostic indicators in children with acute liver failure (ALF).Study design:Retrospective chart review of 210 patients (107 males/103 females; median age: 5.33 years, range: 1–17.4). Patients were followed until discharge (group 1), death (group 2) or liver transplantation (LT; group 3). Data from group 1 were compared to data from the other two groups and King’s College criteria were also assessed.Results:Final diagnoses were: 128 (61%) hepatitis A, 68 (32%) indeterminate and 14 (7%) others. The characteristics of patients who survived (n = 59), died (n = 61) and underwent LT (n = 90) were analysed. In multivariate analysis, prothrombin time and encephalopathy III/IV were the most significant parameters suggesting a high likelihood of death. When King’s College criteria were applied on admission in patients with and without transplantation, the positive predictive values were 96% and 95%, and the negative predictive values were 82% and 82%, respectively.Conclusions:Hepatitis A is the main cause of ALF in children in Argentina. Advanced encephalopathy and prolonged prothrombin time were significantly associated with death or need for LT. King’s College criteria for predicting the outcome of ALF are applicable in children, including those with ALF due to hepatitis A infection.</description><subject>Adolescent</subject><subject>Antibodies</subject><subject>Antigens</subject><subject>Argentina - epidemiology</subject><subject>Attrition (Research Studies)</subject><subject>Bilirubin - blood</subject><subject>Biological and medical sciences</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Disease</subject><subject>Diseases</subject><subject>Epstein-Barr virus</subject><subject>Etiology</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Hepatic Encephalopathy - classification</subject><subject>Hepatic Encephalopathy - mortality</subject><subject>Hepatitis</subject><subject>Hepatitis A</subject><subject>Hepatitis A - complications</subject><subject>Hepatitis B</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>International Normalized Ratio</subject><subject>Liver</subject><subject>Liver failure</subject><subject>Liver Failure, Acute - etiology</subject><subject>Liver Failure, Acute - mortality</subject><subject>Liver Failure, Acute - surgery</subject><subject>Liver Transplantation</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medical sciences</subject><subject>Medical Services</subject><subject>Miscellaneous</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Other diseases. Semiology</subject><subject>Patients</subject><subject>Pediatric diseases</subject><subject>Pediatrics</subject><subject>Predictive Value of Tests</subject><subject>Prevention and actions</subject><subject>Prognosis</subject><subject>Prothrombin Time</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Records (Forms)</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Serology</subject><subject>Statistical Analysis</subject><subject>Statistical Significance</subject><subject>Transplants & implants</subject><subject>Variance analysis</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqF0UtrGzEUBWBRGhon7bq7YijNojDJ1WskLYPpK4SkgTZkJ2TNHSN3PHKkmdL--8qMqSGbrISkT-JcDiFvKZxTyusL1_hzBlCXnSwHL8iMilpXDIR4SWYAwCujtT4mJzmvASjTmr8ix1RpxQw3MyK-p7jqYx6Cn7fODzHleejnW4dNcEMqp86PA8678BtTEaEbE74mR63rMr7Zr6fk5-dPPxZfq-vbL98Wl9fVUhg5VEIL71QLVHgjmhYEqka2pgHtlXLojZZGMC-QyWbJFUrpPNNOF-BahpKfkrPp322KjyPmwW5C9th1rsc4ZquA1gBSPAsZaG4E38H3T-A6jqkvQ1iqmWZK14IXVU1q5Tq0ofexH_DP4GPX4QptmXFxay-pEjWjSu38xeR9ijknbO02hY1Lfy0Fu-vJlp7sric79VRevNvnGJcbbA5-X0wBH_bAZe-6Nrneh3xwxoASUB-ihlwi_r936ZetFVfS3twv7B29v3p4oHeWFv9x8svN-tmU_wA2HrRD</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>Ciocca, M</creator><creator>Ramonet, M</creator><creator>Cuarterolo, M</creator><creator>López, S</creator><creator>Cernadas, C</creator><creator>Álvarez, F</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200801</creationdate><title>Prognostic factors in paediatric acute liver failure</title><author>Ciocca, M ; Ramonet, M ; Cuarterolo, M ; López, S ; Cernadas, C ; Álvarez, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b495t-484ca7f014c94df04e7d5f9d08c77aec985942c4e25db37e55ac28a8d08af2e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Antibodies</topic><topic>Antigens</topic><topic>Argentina - epidemiology</topic><topic>Attrition (Research Studies)</topic><topic>Bilirubin - blood</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Disease</topic><topic>Diseases</topic><topic>Epstein-Barr virus</topic><topic>Etiology</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Hepatic Encephalopathy - classification</topic><topic>Hepatic Encephalopathy - mortality</topic><topic>Hepatitis</topic><topic>Hepatitis A</topic><topic>Hepatitis A - complications</topic><topic>Hepatitis B</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>International Normalized Ratio</topic><topic>Liver</topic><topic>Liver failure</topic><topic>Liver Failure, Acute - etiology</topic><topic>Liver Failure, Acute - mortality</topic><topic>Liver Failure, Acute - surgery</topic><topic>Liver Transplantation</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medical sciences</topic><topic>Medical Services</topic><topic>Miscellaneous</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Other diseases. Semiology</topic><topic>Patients</topic><topic>Pediatric diseases</topic><topic>Pediatrics</topic><topic>Predictive Value of Tests</topic><topic>Prevention and actions</topic><topic>Prognosis</topic><topic>Prothrombin Time</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Records (Forms)</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Serology</topic><topic>Statistical Analysis</topic><topic>Statistical Significance</topic><topic>Transplants & implants</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ciocca, M</creatorcontrib><creatorcontrib>Ramonet, M</creatorcontrib><creatorcontrib>Cuarterolo, M</creatorcontrib><creatorcontrib>López, S</creatorcontrib><creatorcontrib>Cernadas, C</creatorcontrib><creatorcontrib>Álvarez, F</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Education Periodicals</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ciocca, M</au><au>Ramonet, M</au><au>Cuarterolo, M</au><au>López, S</au><au>Cernadas, C</au><au>Álvarez, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic factors in paediatric acute liver failure</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2008-01</date><risdate>2008</risdate><volume>93</volume><issue>1</issue><spage>48</spage><epage>51</epage><pages>48-51</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>Objectives:To study the aetiology, outcome and prognostic indicators in children with acute liver failure (ALF).Study design:Retrospective chart review of 210 patients (107 males/103 females; median age: 5.33 years, range: 1–17.4). Patients were followed until discharge (group 1), death (group 2) or liver transplantation (LT; group 3). Data from group 1 were compared to data from the other two groups and King’s College criteria were also assessed.Results:Final diagnoses were: 128 (61%) hepatitis A, 68 (32%) indeterminate and 14 (7%) others. The characteristics of patients who survived (n = 59), died (n = 61) and underwent LT (n = 90) were analysed. In multivariate analysis, prothrombin time and encephalopathy III/IV were the most significant parameters suggesting a high likelihood of death. When King’s College criteria were applied on admission in patients with and without transplantation, the positive predictive values were 96% and 95%, and the negative predictive values were 82% and 82%, respectively.Conclusions:Hepatitis A is the main cause of ALF in children in Argentina. Advanced encephalopathy and prolonged prothrombin time were significantly associated with death or need for LT. King’s College criteria for predicting the outcome of ALF are applicable in children, including those with ALF due to hepatitis A infection.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><pmid>17872939</pmid><doi>10.1136/adc.2006.115113</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Antibodies Antigens Argentina - epidemiology Attrition (Research Studies) Bilirubin - blood Biological and medical sciences Care and treatment Child Child, Preschool Children Disease Diseases Epstein-Barr virus Etiology Female Gastroenterology. Liver. Pancreas. Abdomen General aspects Hepatic Encephalopathy - classification Hepatic Encephalopathy - mortality Hepatitis Hepatitis A Hepatitis A - complications Hepatitis B Hospitals Humans Infant International Normalized Ratio Liver Liver failure Liver Failure, Acute - etiology Liver Failure, Acute - mortality Liver Failure, Acute - surgery Liver Transplantation Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical prognosis Medical records Medical sciences Medical Services Miscellaneous Mortality Multivariate Analysis Other diseases. Semiology Patients Pediatric diseases Pediatrics Predictive Value of Tests Prevention and actions Prognosis Prothrombin Time Public health. Hygiene Public health. Hygiene-occupational medicine Records (Forms) Retrospective Studies Sepsis Serology Statistical Analysis Statistical Significance Transplants & implants Variance analysis |
| title | Prognostic factors in paediatric acute liver failure |
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