Predictors of outcome in fulminant hepatic failure in children.
Article
in English
| IMSEAR
| ID: sea-64212
ABSTRACT
OBJECTIVE:
To identify the predictors of outcome in fulminant hepatic failure (FHF) in children. STUDYDESIGN:
Prospective cohort study.METHODS:
41 children with FHF were studied. Patient characteristics and findings on examination at the time of hospitalization were noted. Serum biochemistry and screening for hepatotropic viruses (A, B and C) were done in each patient. Patients were treated using a predefined protocol and followed up till death or discharge. Univariate and multivariate analysis was done to find the predictors of outcome.RESULTS:
Hepatitis B was the commonest cause of FHF (11 children; 26.9%). Markers for hepatitis A and C viruses were present in one and two patients, respectively. Serology was negative in 27 children (65.9%), of whom two had history of ingestion of hepatotoxins (antitubercular drugs). The overall mortality was 61%. Irrespective of etiology, the following factors were associated with poor outcome on univariateanalysis:
presence of gastrointestinal (GI) hemorrhage, serum bilirubin more than 10 mg/dL, age 6 years or less, coma of grade 3 or more, presence of infection, prolongation of prothrombin time > 8 s over control, prothrombin concentration < 50%, hypoglycemia (blood glucose < 45 mg/dL), hyponatremia (serum sodium < 125 mEq/L) and hyperkalemia (serum potassium > 5.5 mEq/L). On multiple logistic regression analysis, presence of GI hemorrhage (p = 0.005), degree of coma (p = 0.02) and serum bilirubin level (p = 0.025) were identified as independent predictors of mortality.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Prognosis
/
Female
/
Humans
/
Male
/
Logistic Models
/
Child
/
Child, Preschool
/
Hepatic Encephalopathy
/
Survival Rate
/
Prospective Studies
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Year:
1998
Type:
Article
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