Acute liver failure in Chinese children:a multicenter investigation

作     者：Pan Zhao Chun-Ya Wang Wei-Wei Liu Xi Wang Li-Ming Yu Yan-Rong Sun 

作者机构：Liver Failure Therapy and Research CenterBeijing 302 Hospital (PLA 302 Hospital) Emergency Department Beijing Anzhen Hospital Capital Medical University Intensive Care Unit Emergency Department General Hospital of PLA Postgraduate Division Academy of Military Medical Science Medical Administration Department Changhai Hospital Second Military Medical University Medical Administration Department General Hospital of Jinan Military Region Medical Administration Department General Hospital of Lanzhou Military Region 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2014年第13卷第3期

页      面：276-280页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：acute liver failure children etiology mortality prognosis 

摘      要：BACKGROUND: Currently, no documentation is available regarding Chinese children with acute liver failure(ALF). This study was undertaken to investigate etiologies and outcomes of Chinese children with ***: We retrospectively enrolled 32 pediatric patients with ALF admitted in five hospitals in different areas of China from January 2007 to December 2012. The coagulation indices, serum creatinine, serum lactate dehydrogenase,blood ammonia and prothrombin activity were analyzed; the relationship between these indices and mortality was evaluated by multivariate ***: The most common causes of Chinese children with ALF were indeterminate etiology(15/32), drug toxicity(8/32),and acute cytomegalovirus hepatitis(6/32). Only 1 patient(3.13%)received liver transplantation and the spontaneous mortality of Chinese children with ALF was 58.06%(18/31). Patients who eventually died had higher baseline levels of international normalized ratio(P=0.01), serum creatinine(P=0.04), serum lactate dehydrogenase(P=0.01), blood ammonia(P0.01) and lower prothrombin activity(P=0.01) than those who *** analysis showed that the entry blood ammonia was the only independent factor significantly associated with mortality(odds ratio=1.069, 95% confidence interval 1.023-1.117,P0.01) and it had a sensitivity of 94.74%, a specificity of 84.62%and an accuracy of 90.63% for predicting the death. Based on the established model, with an increase of blood ammonia level,the risk of mortality would increase by 6.9%.CONCLUSIONS: The indeterminate causes predominated in the etiologies of ALF in Chinese children. The spontaneous mortality of pediatric patients with ALF was high, whereas the proportion of patients undergoing liver transplantation was significantly low. Entry blood ammonia was a reliable predictor for the death of pediatric patients with ALF.