Predictors of fatal outcome in fulminant hepatic failure.
OBJECTIVE
To determine prognostic indicators for morbidity and mortality in patients with fulminant hepatic failure.


METHODS
Observational study.


METHODS
Department of Gastroenterology and Hepatology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from April 2003 to June 2005.


METHODS
Forty five patients with confirmed diagnosis of fulminant hepatic failure were included in this study. They were investigated for acute viral serology, complete blood count, liver function tests, renal function tests, serum electrolytes, arterial blood gases, initially daily and then on alternate days. Patients were followed in high dependency/ICU at the Shaikh Zayed Postgraduate Medical Institute. Data were analyzed by logistic regression analysis to identify predictors of mortality and morbidity.


RESULTS
Of the 45 subjects, 31 were males and 14 females. Twenty four patients were positive for acute hepatitis E. Twenty patients recovered fully, whereas 25 died with mortality rate of 55.6 %. Variables i.e. presence of non-A non-B viral hepatitis, serum creatinine > 2.0 mg/dl, serum phosphate > 3.5 mg/dl and sepsis were found to have significant association with mortality on linear correlation. Only serum creatinine more than 2.0 mg/dl, serum phosphate > 3.5 mg/dl and development of sepsis were found to predict the outcome after multivariate analysis.


CONCLUSIONS
Patients with serum creatinine > 2.0 mg/dl, serum phosphate > 3.5 mg/dl and sepsis showed adverse prognosis for survival.
Sarwar
Shahid
S
Department of Gastroenterology and Hepatology, Shaikh Zayed Postgraduate Medical Institute, Lahore. nawalshahid@hotmail.com
Khan
Anwaar A
AA
Alam
Altaf
A
Butt
Arshad Kamal
AK
Ahmad
Irfan
I
Niazi
Aamir Khan
AK
Dilshad
Akif
A
D000328:Adult; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017114:Liver Failure, Acute / Q000097:blood / Q000401:mortality*; D008297:Male; D010710:Phosphates / Q000097:blood; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D015415:Biomarkers; D010710:Phosphates; D003404:Creatinine