Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A: Consecutive case analysis

Hye Sun Shin, Sae Pyul Kim, Sang Hoon Han, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Chae Yoon Chon, Jun Yong Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. Materials and Methods: A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. Results: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD ≥23.5 was significantly more predictive than a SIRS score ≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score ≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. Conclusion: MELD and SIRS scores ≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores ≥3 were valuable in predicting mortality of patients with a MELD ≥23.5.

Original languageEnglish
Pages (from-to)953-959
Number of pages7
JournalYonsei medical journal
Volume55
Issue number4
DOIs
Publication statusPublished - 2014 Jul

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Hepatitis A
Acute Liver Failure
Systemic Inflammatory Response Syndrome
End Stage Liver Disease
Mortality
ROC Curve
Liver Transplantation
Multivariate Analysis
Transplantation
Regression Analysis
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{f6a9e7a69ab847b6925cb9749917f203,
title = "Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A: Consecutive case analysis",
abstract = "Purpose: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. Materials and Methods: A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. Results: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9{\%}) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3{\%}) showed spontaneous survival while 8 (2.6{\%}) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD ≥23.5 was significantly more predictive than a SIRS score ≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score ≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. Conclusion: MELD and SIRS scores ≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores ≥3 were valuable in predicting mortality of patients with a MELD ≥23.5.",
author = "Shin, {Hye Sun} and Kim, {Sae Pyul} and Han, {Sang Hoon} and Kim, {Do Young} and Ahn, {Sang Hoon} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Park, {Jun Yong}",
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Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A : Consecutive case analysis. / Shin, Hye Sun; Kim, Sae Pyul; Han, Sang Hoon; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang Hyub; Chon, Chae Yoon; Park, Jun Yong.

In: Yonsei medical journal, Vol. 55, No. 4, 07.2014, p. 953-959.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A

T2 - Consecutive case analysis

AU - Shin, Hye Sun

AU - Kim, Sae Pyul

AU - Han, Sang Hoon

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Park, Jun Yong

PY - 2014/7

Y1 - 2014/7

N2 - Purpose: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. Materials and Methods: A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. Results: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD ≥23.5 was significantly more predictive than a SIRS score ≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score ≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. Conclusion: MELD and SIRS scores ≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores ≥3 were valuable in predicting mortality of patients with a MELD ≥23.5.

AB - Purpose: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. Materials and Methods: A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. Results: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD ≥23.5 was significantly more predictive than a SIRS score ≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score ≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. Conclusion: MELD and SIRS scores ≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores ≥3 were valuable in predicting mortality of patients with a MELD ≥23.5.

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DO - 10.3349/ymj.2014.55.4.953

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