title: Overweight patients are more susceptible for acute liver failure.
abstract: OBJECTIVE
  To determine a potential correlation of gender, age, and/or body mass index (BMI) with the development of acute-on-chronic liver failure (AOC).
  
  
  METHODS
  A retrospective 2.5-year study employed 34 patients (65% females and 35% males, aged 37.9 +/- 12.6 years) fulfilling established criteria for acute liver failure (ALF). Patients were subdivided into ALF (n = 18) and AOC (n = 16) groups, according to a history of prior chronic liver disease. Causes of liver failure included drug toxicity (52.9%), viral hepatitis (26.5%), and acute excessive ethanol abuse (11.8%). all anamneses were thoroughly reviewed. Throughout the course of the study, the patients were monitored for established clinical signs and laboratory parameters indicating acute liver injury. Gender, age, and BMI were correlated with the clinical outcome.
  
  
  RESULTS
  Twelve patients (35.3%) received an orthotopic liver allograft, with one re-transplantation. Six patients (17.6%), including two transplanted individuals, died in the course of the study. Of all parameters evaluated, BMIs were significantly higher in AOC vs. ALF (p < 0.002), revealing values of > 25 in 62.5% of the AOC patients. When subjected to acute risk factors, elevated BMI clearly coincided with a higher rate of AOC. Importantly, half of all patients initially classified as ALF by employing current criteria thus suffered from AOC coinciding with increased mortality.
  
  
  CONCLUSIONS
  Generally, these results call for a reduction of the BMI. Specifically, our findings argue for a closer BMI monitoring of patients at risk of developing chronic liver disease.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, Essen University, Essen, Germany. ali.canbay@uni-essen.de
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
authors.forename: Shi-Yao
authors.initials: SY
authors.lastname: Chen
authors.forename: Robert K
authors.initials: RK
authors.lastname: Gieseler
authors.forename: Massimo
authors.initials: M
authors.lastname: Malago
authors.forename: Marc
authors.initials: M
authors.lastname: Karliova
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Treichel
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors