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한국인에서 전격성 간부전의 임상적 특징 및 예후 인자

Other Titles
 Clinical Features and Prognostic Factors of Fulminant Hepatic Failure in Koreans 
 신성재  ;  안상훈  ;  문영명  ;  전재윤  ;  한광협  ;  이관식  ;  백용한  ;  이재현  ;  김병창  ;  김자경  ;  김희만 
 Korean Journal of Hepatology (대한간학회지), Vol.10(4) : 298-307, 2004 
Journal Title
Korean Journal of Hepatology(대한간학회지)
Issue Date
Adult ; Female ; Humans ; Liver Failure, Acute/diagnosis* ; Liver Failure, Acute/etiology ; Liver Failure, Acute/surgery ; Liver Transplantation ; Male ; Middle Aged ; Prognosis
Fulminant hepatic failure ; Hepatic encephalopathy ; Prognostic factors ; Hepatitis B virus ; Drug
Background: There have been scant reports on the prognostic factors of fulminant hepatic failure for selecting the patients who need liver transplantation. We investigated the clinical features and prognostic factors throughout the clinical course of the disease in Korean patients with fulminant hepatic failure.

Methods: Between 1992 and 2003, a total of 60 patients with fulminant hepatic failure were divided into the survival group and the non-survival group, and these groups were compared according to gender, age, etiology, values of the laboratory tests, grade of the encephalopathy that was obtained at the time of admission and the worst clinical status (hepatic encephalopathy).

Results: The mean age of the total patients was 40.9 years (M:F=31:29) and the survival rate was 28.3% (n=17). Drugs (n=25, 12 herbal medicines) and viral infection (n=24, 18 HBV infection) were most common causes. On univariate analysis, the WBC, AST, ALT, total bilirubin and HE IV stage at the time of admission were the significant factors for a poor prognosis. Total bilirubin, albumin and HE IV stage also remained as significant factors at the time of the worst clinical status. On multivariate analysis, total bilirubin (P=0.033) and ALT (P=0.042) at admission were the prognostic factors, and the progression to HE IV stage (P=0.019) or hypoalbuminemia (P=0.028) during hospitalization represented the significant factors for a poor prognosis.

Conclusions: In contrast to Western countries, HBV infection and herbal medicines were major causes of fulminant hepatic failure in Korea. The total serum bilirubin level and progressive hyperbilirubinemia with HE (stage IV) during hospitalization seemed to be the most important prognostic factors, and liver transplantation should be considered before the patient reaches this status.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byung Chang(김병창)
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Kim, Hee Man(김희만)
Paik, Yong Han(백용한)
Shin, Sung Jae(신성재)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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