Original article—liver, pancreas, and biliary tractPrognostic Implications of Lactate, Bilirubin, and Etiology in German Patients With Acute Liver Failure
Section snippets
Patients and Clinical Assessment
We retrospectively identified 210 patients with acute hepatic dysfunction treated at the intensive care unit of our institution between 1996 and 2005. Of those, 102 patients (Figure 1) fulfilled the diagnostic criteria of ALF as initially published by Trey and Davidson1 as well as those recently defined by the American Association for the Study of Liver Diseases (ie, hepatic encephalopathy, acute-onset increase of INR >1.5, and absence of signs of chronic liver disease in clinical and
Demographic Characteristics and Clinical Data
Of the 102 patients with acute liver failure, 72 (71%) were women. The median age of the group was 38 years (range, 16–74 years). Exact data on the duration of jaundice before onset of encephalopathy were available for 54 patients. The median interval between jaundice and onset of encephalopathy was 6 days (range, 0–40 days) in the overall cohort, 1 day (range, 0–39 days) in patients surviving without OLT (referred to as OLT-free survival), and 9 days (0–40 days) in those who underwent
Discussion
ALF is estimated to cause approximately 3.5 deaths per million people per year in industrialized countries.26 The currently largest prospective study on ALF, which enrolled 308 patients in the United States, demonstrated a 43% chance of survival without OLT and an overall survival of 67%.5 Our study represented a large cohort of patients with acetaminophen and non–acetaminophen-induced ALF in central Europe. Of 102 patients, 38% survived without transplantation. The overall survival 8 weeks
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