Document Detail


Early indicators of prognosis in fulminant hepatic failure.
MedLine Citation:
PMID:  2490426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The successful use of orthotopic liver transplantation in fulminant hepatic failure has created a need for early prognostic indicators to select the patients most likely to benefit at a time when liver transplantation is still feasible. Univariate and multivariate analysis was performed on 588 patients with acute liver failure managed medically during 1973-1985, to identify the factors most likely to indicate a poor prognosis. In acetaminophen-induced fulminant hepatic failure, survival correlated with arterial blood pH, peak prothrombin time, and serum creatinine--a pH less than 7.30, prothrombin time greater than 100 s, and creatinine greater than 300 mumol/L indicating a poor prognosis. In patients with viral hepatitis and drug reactions three static variables [etiology (non A, non B hepatitis or drug reactions), age less than 11 and greater than 40 yr, duration of jaundice before the onset of encephalopathy greater than 7 days] and two dynamic variables (serum bilirubin greater than 300 mumol/L and prothrombin time greater than 50 s) indicated a poor prognosis. The value of these indicators in determining outcome was tested retrospectively in a further 175 patients admitted during 1986-1987, leading to the construction of models for the selection of patients for liver transplantation.
Authors:
J G O'Grady; G J Alexander; K M Hayllar; R Williams
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastroenterology     Volume:  97     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1989 Aug 
Date Detail:
Created Date:  1989-08-18     Completed Date:  1989-08-18     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  439-45     Citation Subset:  AIM; IM    
Affiliation:
Liver Unit, King's College School of Medicine, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / poisoning
Adult
Child
Drug Hypersensitivity / complications
Drug-Induced Liver Injury / complications
Halothane / adverse effects
Hepatitis, Viral, Human / complications
Humans
Liver Diseases / etiology,  mortality*
Liver Transplantation
Prognosis
Retrospective Studies
Risk Factors
Statistics as Topic
Chemical
Reg. No./Substance:
103-90-2/Acetaminophen; 151-67-7/Halothane
Comments/Corrections
Comment In:
Gastroenterology. 1991 May;100(5 Pt 1):1480-1   [PMID:  2013397 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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