Clinical features and prognostic factors of fulminant hepatic failure in Koreans

Sung Jae Shin, SangHoon Ahn, Heeman Kim, Ja Kyung Kim, Byung Chang Kim, Jae Hyun Lee, Yong Han Paik, Kwan Sik Lee, KwangHyub Han, Chae Yoon Chon, Young Myoung Moon

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Abstract

BACKGROUND/AIMS: There have been scant reports on the prognostic factors of fulminant hepatic failure for selecting the patients who need liver transplantation. We investigated the clinical features and prognostic factors throughout the clinical course of the disease in Korean patients with fulminant hepatic failure. METHODS: Between 1992 and 2003, a total of 60 patients with fulminant hepatic failure were divided into the survival group and the non-survival group, and these groups were compared according to gender, age, etiology, values of the laboratory tests, grade of the encephalopathy that was obtained at the time of admission and the worst clinical status (hepatic encephalopathy). RESULTS: The mean age of the total patients was 40.9 years (M:F=31:29) and the survival rate was 28.3% (n=17). Drugs (n=25, 12 herbal medicines) and viral infection (n=24, 18 HBV infection) were most common causes. On univariate analysis, the WBC, AST, ALT, total bilirubin and HE IV stage at the time of admission were the significant factors for a poor prognosis. Total bilirubin, albumin and HE IV stage also remained as significant factors at the time of the worst clinical status. On multivariate analysis, total bilirubin (P=0.033) and ALT (P=0.042) at admission were the prognostic factors, and the progression to HE IV stage (P=0.019) or hypoalbuminemia (P=0.028) during hospitalization represented the significant factors for a poor prognosis. CONCLUSIONS: In contrast to Western countries, HBV infection and herbal medicines were major causes of fulminant hepatic failure in Korea. The total serum bilirubin level and progressive hyperbilirubinemia with HE (stage IV) during hospitalization seemed to be the most important prognostic factors, and liver transplantation should be considered before the patient reaches this status.

Original languageEnglish
Pages (from-to)298-307
Number of pages10
JournalThe Korean journal of hepatology
Volume10
Issue number4
Publication statusPublished - 2004 Jan 1

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Acute Liver Failure
Bilirubin
Herbal Medicine
Liver Transplantation
Hospitalization
Hypoalbuminemia
Hyperbilirubinemia
Hepatic Encephalopathy
Brain Diseases
Virus Diseases
Korea
Infection
Albumins
Multivariate Analysis
Survival Rate
Survival
Serum
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Shin, S. J., Ahn, S., Kim, H., Kim, J. K., Kim, B. C., Lee, J. H., ... Moon, Y. M. (2004). Clinical features and prognostic factors of fulminant hepatic failure in Koreans. The Korean journal of hepatology, 10(4), 298-307.
Shin, Sung Jae ; Ahn, SangHoon ; Kim, Heeman ; Kim, Ja Kyung ; Kim, Byung Chang ; Lee, Jae Hyun ; Paik, Yong Han ; Lee, Kwan Sik ; Han, KwangHyub ; Chon, Chae Yoon ; Moon, Young Myoung. / Clinical features and prognostic factors of fulminant hepatic failure in Koreans. In: The Korean journal of hepatology. 2004 ; Vol. 10, No. 4. pp. 298-307.
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title = "Clinical features and prognostic factors of fulminant hepatic failure in Koreans",
abstract = "BACKGROUND/AIMS: There have been scant reports on the prognostic factors of fulminant hepatic failure for selecting the patients who need liver transplantation. We investigated the clinical features and prognostic factors throughout the clinical course of the disease in Korean patients with fulminant hepatic failure. METHODS: Between 1992 and 2003, a total of 60 patients with fulminant hepatic failure were divided into the survival group and the non-survival group, and these groups were compared according to gender, age, etiology, values of the laboratory tests, grade of the encephalopathy that was obtained at the time of admission and the worst clinical status (hepatic encephalopathy). RESULTS: The mean age of the total patients was 40.9 years (M:F=31:29) and the survival rate was 28.3{\%} (n=17). Drugs (n=25, 12 herbal medicines) and viral infection (n=24, 18 HBV infection) were most common causes. On univariate analysis, the WBC, AST, ALT, total bilirubin and HE IV stage at the time of admission were the significant factors for a poor prognosis. Total bilirubin, albumin and HE IV stage also remained as significant factors at the time of the worst clinical status. On multivariate analysis, total bilirubin (P=0.033) and ALT (P=0.042) at admission were the prognostic factors, and the progression to HE IV stage (P=0.019) or hypoalbuminemia (P=0.028) during hospitalization represented the significant factors for a poor prognosis. CONCLUSIONS: In contrast to Western countries, HBV infection and herbal medicines were major causes of fulminant hepatic failure in Korea. The total serum bilirubin level and progressive hyperbilirubinemia with HE (stage IV) during hospitalization seemed to be the most important prognostic factors, and liver transplantation should be considered before the patient reaches this status.",
author = "Shin, {Sung Jae} and SangHoon Ahn and Heeman Kim and Kim, {Ja Kyung} and Kim, {Byung Chang} and Lee, {Jae Hyun} and Paik, {Yong Han} and Lee, {Kwan Sik} and KwangHyub Han and Chon, {Chae Yoon} and Moon, {Young Myoung}",
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Shin, SJ, Ahn, S, Kim, H, Kim, JK, Kim, BC, Lee, JH, Paik, YH, Lee, KS, Han, K, Chon, CY & Moon, YM 2004, 'Clinical features and prognostic factors of fulminant hepatic failure in Koreans', The Korean journal of hepatology, vol. 10, no. 4, pp. 298-307.

Clinical features and prognostic factors of fulminant hepatic failure in Koreans. / Shin, Sung Jae; Ahn, SangHoon; Kim, Heeman; Kim, Ja Kyung; Kim, Byung Chang; Lee, Jae Hyun; Paik, Yong Han; Lee, Kwan Sik; Han, KwangHyub; Chon, Chae Yoon; Moon, Young Myoung.

In: The Korean journal of hepatology, Vol. 10, No. 4, 01.01.2004, p. 298-307.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical features and prognostic factors of fulminant hepatic failure in Koreans

AU - Shin, Sung Jae

AU - Ahn, SangHoon

AU - Kim, Heeman

AU - Kim, Ja Kyung

AU - Kim, Byung Chang

AU - Lee, Jae Hyun

AU - Paik, Yong Han

AU - Lee, Kwan Sik

AU - Han, KwangHyub

AU - Chon, Chae Yoon

AU - Moon, Young Myoung

PY - 2004/1/1

Y1 - 2004/1/1

N2 - BACKGROUND/AIMS: There have been scant reports on the prognostic factors of fulminant hepatic failure for selecting the patients who need liver transplantation. We investigated the clinical features and prognostic factors throughout the clinical course of the disease in Korean patients with fulminant hepatic failure. METHODS: Between 1992 and 2003, a total of 60 patients with fulminant hepatic failure were divided into the survival group and the non-survival group, and these groups were compared according to gender, age, etiology, values of the laboratory tests, grade of the encephalopathy that was obtained at the time of admission and the worst clinical status (hepatic encephalopathy). RESULTS: The mean age of the total patients was 40.9 years (M:F=31:29) and the survival rate was 28.3% (n=17). Drugs (n=25, 12 herbal medicines) and viral infection (n=24, 18 HBV infection) were most common causes. On univariate analysis, the WBC, AST, ALT, total bilirubin and HE IV stage at the time of admission were the significant factors for a poor prognosis. Total bilirubin, albumin and HE IV stage also remained as significant factors at the time of the worst clinical status. On multivariate analysis, total bilirubin (P=0.033) and ALT (P=0.042) at admission were the prognostic factors, and the progression to HE IV stage (P=0.019) or hypoalbuminemia (P=0.028) during hospitalization represented the significant factors for a poor prognosis. CONCLUSIONS: In contrast to Western countries, HBV infection and herbal medicines were major causes of fulminant hepatic failure in Korea. The total serum bilirubin level and progressive hyperbilirubinemia with HE (stage IV) during hospitalization seemed to be the most important prognostic factors, and liver transplantation should be considered before the patient reaches this status.

AB - BACKGROUND/AIMS: There have been scant reports on the prognostic factors of fulminant hepatic failure for selecting the patients who need liver transplantation. We investigated the clinical features and prognostic factors throughout the clinical course of the disease in Korean patients with fulminant hepatic failure. METHODS: Between 1992 and 2003, a total of 60 patients with fulminant hepatic failure were divided into the survival group and the non-survival group, and these groups were compared according to gender, age, etiology, values of the laboratory tests, grade of the encephalopathy that was obtained at the time of admission and the worst clinical status (hepatic encephalopathy). RESULTS: The mean age of the total patients was 40.9 years (M:F=31:29) and the survival rate was 28.3% (n=17). Drugs (n=25, 12 herbal medicines) and viral infection (n=24, 18 HBV infection) were most common causes. On univariate analysis, the WBC, AST, ALT, total bilirubin and HE IV stage at the time of admission were the significant factors for a poor prognosis. Total bilirubin, albumin and HE IV stage also remained as significant factors at the time of the worst clinical status. On multivariate analysis, total bilirubin (P=0.033) and ALT (P=0.042) at admission were the prognostic factors, and the progression to HE IV stage (P=0.019) or hypoalbuminemia (P=0.028) during hospitalization represented the significant factors for a poor prognosis. CONCLUSIONS: In contrast to Western countries, HBV infection and herbal medicines were major causes of fulminant hepatic failure in Korea. The total serum bilirubin level and progressive hyperbilirubinemia with HE (stage IV) during hospitalization seemed to be the most important prognostic factors, and liver transplantation should be considered before the patient reaches this status.

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