Prognostic Indicators for Acute Liver Failure Development and Mortality in Patients with Hepatitis A: Consecutive Case Analysis
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Purpose: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patientswith HA. Materials and Methods: A total of 304 patients with HA admittedto our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. Results: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneoussurvival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictivefactors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD ≥23.5 was significantly more predictive than a SIRS score ≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score ≥23.5, King’s College Hospital criteria (KCC) and SIRS scores were predictivefactors associated with death/transplantation in multivariate analysis. Conclusion:MELD and SIRS scores ≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores ≥3 were valuable in predictingmortality of patients with a MELD ≥23.5.
Abstract
Purpose: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patientswith HA. Materials and Methods: A total of 304 patients with HA admittedto our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. Results: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneoussurvival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictivefactors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD ≥23.5 was significantly more predictive than a SIRS score ≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score ≥23.5, King’s College Hospital criteria (KCC) and SIRS scores were predictivefactors associated with death/transplantation in multivariate analysis. Conclusion:MELD and SIRS scores ≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores ≥3 were valuable in predictingmortality of patients with a MELD ≥23.5.
참고문헌 (35)
- Cuthbert JA, "Hepatitis A: old and new", Clin Microbiol Rev, 14, pp.38~58 (2001)
- 강철인, "Incidence and Seroprevalence of Hepatitis A Virus Infections among Young Korean Soldiers", Journal of Korean Medical Science, 22(3), pp.546~548 (2007), 대한의학회
- Jeong SH, "Hepatitis A: clinical manifestations and management", Intervirology, 53, pp.15~19 (2010)
- Jung YK, "Epidemiology and clinical features of acute hepatitis A: from the domestic perspective", Korean J Hepatol, 15, pp.438~445 (2009)
- Schiødt FV, "Viral hepatitis-related acute liver failure", Am J Gastroenterol, 98, pp.448~453 (2003)
- Schiodt FV, "Etiology and outcome for 295 patients with acute liver failure in the United States", Liver Transpl Surg, 5, pp.29~34 (1999)
- 김진동, "응급 간이식을 받은 전격성 A형간염 환자의 임상 양상: 다른 원인에 의한 급성 간부전 환자와의 비교", Clinical and Molecular Hepatology, 16(1), pp.19~28 (2010), 대한간학회
- Polson J, "Assessment of prognosis in acute liver failure", Semin Liver Dis, 28, pp.218~225 (2008)
- Rolando N, "The systemic inflammatory response syndrome in acute liver failure", Hepatology, 32(4 Pt 1), pp.734~739 (2000)
- England JM, "Red-cell-volume distribution curves and the measurement of anisocytosis", Lancet, 1, pp.701~703 (1974)
- Oh J, "Prognostic value of change in red cell distribution width 1 month after discharge in acute decompensated heart failure patients.", CIRCULATION JOURNAL, 76(1), pp.109~116 (2012), JAPANESE CIRCULATION SOC
- Oh HJ, "Red blood cell distribution width is an independent predictor of mortality in acute kidney injury patients treated with continuous renal replacement therapy", NEPHROLOGY DIALYSIS TRANSPLANTATION, 27(2), pp.589~594 (2012), OXFORD UNIV PRESS
- Sadaka F, "Red cell distribution width and outcome in patients with septic shock", J Intensive Care Med, 28, pp.307~313 (2013)
- Lou Y, "Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B", PLoS One, 7, pp.e37644~ (2012)
- Corrao G, "Independent and combined action of hepatitis C virus infection and alcohol consumption on the risk of symptomatic liver cirrhosis", Hepatology, 27, pp.914~919 (1998)
- Mullen KD, "Review of the final report of the 1998 Working Party on definition, nomenclature and diagnosis of hepatic encephalopathy", Aliment Pharmacol Ther, 25(Suppl 1), pp.11~16 (2007)
- Polson J, "AASLD position paper: the management of acute liver failure", Hepatology, 41, pp.1179~1197 (2005)
- Thadhani R, "Acute renal failure", N Engl J Med, 334, pp.1448~1460 (1996)
- Wiesner R, "Model for end-stage liver disease (MELD) and allocation of donor livers", Gastroenterology, 124, pp.91~96 (2003)
- Anand AC, "Early indicators of prognosis in fulminant hepatic failure: an assessment of the King’s criteria", J Hepatol, 26, pp.62~68 (1997)
- NeSmith EG, "Systemic inflammatory response syndrome score and race as predictors of length of stay in the intensive care unit", Am J Crit Care, 18, pp.339~346 (2009)
- Williams R, "Classification, etiology, and considerations of outcome in acute liver failure", Semin Liver Dis, 16, pp.343~348 (1996)
- Ozsoylu S, "Acute hepatic failure related to hepatitis A", Lancet, 1, pp.901~ (1989)
- Kwon SY, "Current status of liver diseases in Korea: hepatitis A", Korean J Hepatol, 15(Suppl 6), pp.S7~S12 (2009)
- Vaquero J, "Infection and the progression of hepatic encephalopathy in acute liver failure", Gastroenterology, 125, pp.755~764 (2003)
- Craig DG, "The systemic inflammatory response syndrome and sequential organ failure assessment scores are effective triage markers following paracetamol (acetaminophen) overdose", Aliment Pharmacol Ther, 34, pp.219~228 (2011)
- Kamath PS, "A model to predict survival in patients with end-stage liver disease", Hepatology, 33, pp.464~470 (2001)
- Kamath PS, "The model for end-stage liver disease (MELD)", Hepatology, 45, pp.797~805 (2007)
- Dhiman RK, "Early indicators of prognosis in fulminant hepatic failure: an assessment of the Model for End-Stage Liver Disease (MELD) and King’s College Hospital criteria", Liver Transpl, 13, pp.814~821 (2007)
- Katoonizadeh A, "MELD score to predict outcome in adult patients with non-acetaminophen-induced acute liver failure", Liver Int, 27, pp.329~334 (2007)
- Perlstein TS, "Red blood cell distribution width and mortality risk in a community-based prospective cohort", Arch Intern Med, 169, pp.588~594 (2009)
- Junaidi O, "Aging liver and hepatitis", Clin Geriatr Med, 23, pp.889~903 (2007)
- Lednar WM, "Frequency of illness associated with epidemic hepatitis A virus infections in adults", Am J Epidemiol, 122, pp.226~233 (1985)
- Hee Kyoung Choi, "Clinical Features of Re-Emerging Hepatitis A: An Analysis of Patients Hospitalized during an Urban Epidemic in Korea", Yonsei Medical Journal, 52(4), pp.686~691 (2011), 연세대학교의과대학
- Shin SR, "Does chronic hepatitis B infection affect the clinical course of acute hepatitis A?", JOURNAL OF MEDICAL VIROLOGY, 85(1), pp.43~48 (2013), WILEY-BLACKWELL