ABSTRACT
Background: Acute liver failure (ALF) is a rare medical emergency and devastating clinical syndrome associated with high mortality. Indeterminate ALF still forms a significant number of cases in India as well in the world. We aimed to determine the clinical profile and outcome of patients with indeterminate ALF.Methods: A total of 30 patients with a diagnosis of Indeterminate ALF were included in the study. The variables evaluated were demographic, signs and symptoms, biochemical parameters, severity of liver injury, outcome, complications and duration of hospital stay.Results: Overall mortality was 18 (60%). Majority of the patients were females (56.7%). Majority of patients (60%) had grade III and IV encephalopathy at the time of admission. The mean age in Survived group was 30.6±11.6 years and in Died group was 42.6±10.2 years (p=0.005). INR, bilirubin AST, ALT and creatinine were significantly higher in Died group than Survived group. Mean grade of coma was significantly higher in Died group than Survived group (p=0.010). MELD Score was significantly higher in Died group 35.8±6.7 than Survived group 27.5±5.8 (P = 0.001). Sepsis and renal failure occurred more frequently in Died group. Duration of hospital stay was also significantly more in Died group versus Survived group (p=0.003).Conclusions: Indeterminate ALF disproportionately affected young females. Mortality was as high as 60%. The marked difference in spontaneous survival can be explained by the severity of hepatic dysfunction on admission and more frequent complications.