Clinical outcomes and predictive factors of spontaneous survival in patients with fulminant hepatitis A / 대한간학회지
The Korean Journal of Hepatology
;
: 474-482, 2008.
Artículo
en Coreano
| WPRIM
| ID: wpr-147560
ABSTRACT
BACKGROUNDS/AIMS:
The occurrence of acute hepatitis A is increasing and its progression to fulminant hepatic failure (FHF) is frequent. We investigated the frequency and clinical outcomes of fulminant hepatitis A and also analyzed the predictive factors of spontaneous survival.METHODS:
A total of 568 patients presented with acute hepatitis A from January 2003 to June 2008, of which the 35 (6.2%) patients with FHF were divided into two groups spontaneous survival and transplant/death. These two groups were compared according to various clinical features including the MELD score and King's College Hospital (KCH) criteria.RESULTS:
The rate of FHF development increased over time among patients with acute hepatitis A 0% in 2003, 3.4% in 2004, 3.2% in 2005, 6.0% in 2006, 7.7% in 2007, and 13.0% in 2008. Twenty patients (57.1%) showed spontaneous survival, 13 (37.1%) received liver transplantation, and 5 (14.3%) died during hospitalization. The two groups of spontaneous survival (N=20) and transplant/death (N=15) showed significant differences in prothrombin time at admission and at its worst value, albumin at its worst value, and hepatic encephalopathy grade at admission and at its worst value. The MELD score was lower in the spontaneous-survival group than in the transplant/death group (27.0+/-7.8 vs. 37.0+/-7.1, mean+/-SD; P=0.001). However, KCH criteria did not differ significantly between the two groups. On multivariate analysis, HEP grade was the only significant predictive factor, being negatively correlated with spontaneous survival (OR=0.068, P=0.025).CONCLUSIONS:
FHF due to hepatitis A has increased in recent years, and in our cohort the HEP grade was closely associated with spontaneous survival.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pronóstico
/
Índice de Severidad de la Enfermedad
/
Análisis de Supervivencia
/
Enfermedad Aguda
/
Análisis Multivariante
/
Valor Predictivo de las Pruebas
/
Estudios Retrospectivos
/
Trasplante de Hígado
/
Resultado del Tratamiento
/
Fallo Hepático Agudo
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adulto
/
Femenino
/
Humanos
/
Masculino
Idioma:
Coreano
Revista:
The Korean Journal of Hepatology
Año:
2008
Tipo del documento:
Artículo
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