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Prognostic Value of Model for End-Stage Liver Disease Scores in Patients with Fulminant Hepatic Failure

Authors
 H.S. Lee  ;  G.H. Choi  ;  D.J. Joo  ;  M.S. Kim  ;  S.I. Kim  ;  K.H. Han  ;  S.H. Ahn  ;  D.Y. Kim  ;  J.Y. Park  ;  J.S. Choi 
Citation
 Transplantation Proceedings, Vol.45(8) : 2992-2994, 2013 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2013
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Liver Failure, Acute/etiology ; Liver Failure, Acute/physiopathology* ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Young Adult
Keywords
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Liver Failure, Acute/etiology ; Liver Failure, Acute/physiopathology* ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Young Adult
Abstract
BACKGROUND: This study was undertaken to investigate risk factors of mortality in patients with fulminant hepatic failure (FHF). METHODS: Fifty-three patients with FHF treated from January 2006 to April 2011 were allocated to a spontaneous survival group (group 1), a death without liver transplantation (LT) group (group 2), and an LT group (group 3). To analyze risk factors associated with mortality in FHF, we excluded group 3 patients. Clinical features, Model for End-Stage Liver Disease (MELD) scores, and King's College Hospital criteria at the time of hepatic encephalopathy in group 2 were compared with those of group 1. RESULTS: The causes of FHF were acute viral infection (n = 29, hepatitis A:B, 28:1), drugs (n = 18; including 4 acetaminophen and 14 herbal medication), autoimmune (n = 4), and miscellaneous (n = 2). Of the 53 patients, 19 were allocated to group 1, 18 to group 2, and 16 to group 3. According to univariate analysis, risk factors for mortality in group 2 were acute renal failure requiring renal replacement therapy and a MELD score ≥30 at the time of hepatic encephalopathy. However, by multivariate analysis, a MELD score ≥30 was the only independent risk factor for mortality in group 2 (P = .042; hazard ratio, 4.500). CONCLUSIONS: A MELD score ≥30 was found to be the only independent risk factor of mortality in FHF patients without LT. Therefore, the findings of this study suggest that these patients may need emergent LT for survival.
Full Text
http://www.sciencedirect.com/science/article/pii/S0041134513007793
DOI
10.1016/j.transproceed.2013.08.036
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Hyung Soon(이형순)
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89255
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