Etiology and prognostic indicators of pediatric acute liver failure

FU Haiyan; ZHAO Ruiqin; BAI Gelan; YIN Chunlan; JIA Xiaoyun; LI Guigui; LI Xiaolei

doi:10.7619/jcmp.20201505

Journal of Clinical Medicine in Practice > 2021 > 25(8): 79-83. > DOI: 10.7619/jcmp.20201505

FU Haiyan, ZHAO Ruiqin, BAI Gelan, YIN Chunlan, JIA Xiaoyun, LI Guigui, LI Xiaolei. Etiology and prognostic indicators of pediatric acute liver failure[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 79-83. DOI: 10.7619/jcmp.20201505

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Etiology and prognostic indicators of pediatric acute liver failure

Digestive Department, Children's Hospital of Hebei Province, Shijiazhuang, Hebei, 050031

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Received Date: November 21, 2020
Available Online: March 24, 2021
Published Date: April 27, 2021

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Abstract

Objective To analyze the etiology and the prognostic indicators of pediatric acute liver failure (PALF).
Methods A retrospective study was performed on the data of 64 patients with PALF. The patients were then divided into survival group and death group based on their prognosis. Age, gender, biochemical indicators and pediatric of end-stage liver disease (PELD) were compared between the two groups.
Results The common causes of PALF were identified as genetic and metabolic diseases (18 cases), followed by infectious diseases (13 cases), drug adverse reations and toxicity(8 cases), hematopathy (4 cases), immunologic liver diseases (2 cases), ischemic liver disease (1 case), and unclear causes (18 cases). The levels of total bilirubin (TB), international standardized ratio (INR) and PELD score in the death group were higher than those in the survival group, and the level of γ-glutamyl transpeptidase (GGT) in the death group was lower than that in the survival group (P < 0.05 or P < 0.01). Receiver operating characteristic (ROC) curve analysis showed that the combined area under the curve of GGT, TB and INR in combination was 0.793 (95%CI, 0.684 to 0.903), and the prognostic sensitivity and specificity of PALF diagnosis were 0.828 and 0.626, respectively.
Conclusion Inherited metabolic disorders are the most common known cause of PALF. For patients with PALF, higher levels of TB, INR and lower level of GGT may indicate a poor prognosis.
- pediatric acute liver failure,
- etiology,
- prognosis,
- international standardized ratio,
- total bilirubin,
- γ-glutamyl transpeptidase

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