Prognostic models for acute liver failure.
BACKGROUND
Acute liver failure (ALF) remains a dramatic and unpredictable disease with high morbidity and mortality. Early and accurate prognostic assessment of patients with ALF is critically important for optimum clinical pathway.


METHODS
Five English-language medical databases, MEDLINE, ScienceDirect, OVID, Springer Link and Wiley Interscience were searched for articles on "acute liver failure", "prognosis", and related topics.


RESULTS
Multi-variable prognostic models including the King's College Hospital criteria and the model for end-stage liver disease score have been widely used in determination of the prognosis of ALF, but the results are far from satisfactory. Other prognostic indicators including serum Gc-globulin, arterial blood lactate, serum phosphate, arterial blood ammonia, and serum alpha-fetoprotein are promising but await further assessement.


CONCLUSIONS
A reliable prognostic model to be developed in the future should not only have predictive value for poor outcome but also help to predict the survival of patients without a liver transplantation. Further studies are necessary to assess the prognostic accuracy of any new models.
Du
Wei-Bo
WB
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. ljli@zju.edu.cn.
Pan
Xiao-Ping
XP
Li
Lan-Juan
LJ
D000641:Ammonia / Q000097:blood; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D017114:Liver Failure, Acute / Q000097:blood / Q000401:mortality*; D008954:Models, Biological; D010710:Phosphates / Q000097:blood; D011379:Prognosis; D014809:Vitamin D-Binding Protein / Q000097:blood; D000509:alpha-Fetoproteins / Q000032:analysis
D010710:Phosphates; D014809:Vitamin D-Binding Protein; D000509:alpha-Fetoproteins; D019344:Lactic Acid; D000641:Ammonia