title: Model for end-stage liver disease score as a predictor of short-term outcome in patients with drug-induced liver injury.
abstract: OBJECTIVE
  The purposes of this study were to investigate the clinical presentation, cause and outcome of drug-induced liver injury (DILI) and to evaluate the predictive value of the model for end-stage liver disease (MELD) score in DILI.
  
  
  METHODS
  Patients diagnosed with DILI between January 1, 2010 and December 31, 2012 in the Emergency Department at Asan Medical Center in Seoul, Korea were analyzed retrospectively. The primary end point was poor outcome, defined as liver transplantation or death within 30 days of the initial hospital visit.
  
  
  RESULTS
  Of 213 patients, 13.1% had a 30-day poor outcome. Folk remedies were the most common cause of DILI in 147 patients (69%). Univariate logistic regression analysis showed that multiple drugs (odds ratio [OR] 2.30, 95% confidence interval [CI]: 1.03-5.15), concurrent alcohol consumption (OR 3.69, 95% CI: 1.03-13.18), white blood cell (WBC) count (OR 1.17, 95% CI: 1.07-1.28), hemoglobin (Hb) (OR 0.60, 95% CI: 0.49-0.74), platelet count (OR 0.993, 95% CI: 0.987-0.998), total bilirubin (OR 1.09, 95% CI: 1.06-1.13) and MELD (OR 1.23, 95% CI: 1.15-1.32) were significantly associated with 30-day poor outcomes. Multivariate analysis showed that the MELD (OR 1.21, 95% CI: 1.12-1.30) and Hb (OR 0.77, 95% CI: 0.61-0.98) were independent predictors of poor outcome. For 30-day mortality, the c-statistics for MELD alone and for combination of MELD and Hb were 0.93 (95% CI: 0.89-0.97) and 0.94 (95% CI: 0.90-0.97), respectively.
  
  
  CONCLUSIONS
  The outcome of patients with DILI was poor. MELD score and Hb were reliable predictors of short-term outcome in patients with DILI.
authors: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea.
authors: Rubi
authors: R
authors: Jeong
authors: Yoon-Seon
authors: YS
authors: Lee
authors: Changhwan
authors: C
authors: Sohn
authors: Jin
authors: J
authors: Jeon
authors: Shin
authors: S
authors: Ahn
authors: Kyoung Soo
authors: KS
authors: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D001663:Bilirubin / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood* / Q000209:etiology* / Q000601:surgery; D003661:Decision Support Techniques; D058625:End Stage Liver Disease / Q000209:etiology; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D016031:Liver Transplantation; D008297:Male; D008519:Medicine, Traditional / Q000009:adverse effects; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D001663:Bilirubin
keywords: MELD score; drug-induced liver injury; liver transplantation; mortality; prognosis