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The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study

BACKGROUND: Acute liver failure (ALF) is uncommon but progresses rapidly with high mortality. We investigated the incidence, etiologies, outcomes, and predictive factors for 30-day mortality in patients with ALF. METHODS: We conducted a population-based study of ALF patients hospitalized between 200...

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Autores principales: Thanapirom, Kessarin, Treeprasertsuk, Sombat, Soonthornworasiri, Ngamphol, Poovorawan, Kittiyod, Chaiteerakij, Roongruedee, Komolmit, Piyawat, Phaosawasdi, Kamthorn, Pinzani, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348628/
https://www.ncbi.nlm.nih.gov/pubmed/30691414
http://dx.doi.org/10.1186/s12876-019-0935-y
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author Thanapirom, Kessarin
Treeprasertsuk, Sombat
Soonthornworasiri, Ngamphol
Poovorawan, Kittiyod
Chaiteerakij, Roongruedee
Komolmit, Piyawat
Phaosawasdi, Kamthorn
Pinzani, Massimo
author_facet Thanapirom, Kessarin
Treeprasertsuk, Sombat
Soonthornworasiri, Ngamphol
Poovorawan, Kittiyod
Chaiteerakij, Roongruedee
Komolmit, Piyawat
Phaosawasdi, Kamthorn
Pinzani, Massimo
author_sort Thanapirom, Kessarin
collection PubMed
description BACKGROUND: Acute liver failure (ALF) is uncommon but progresses rapidly with high mortality. We investigated the incidence, etiologies, outcomes, and predictive factors for 30-day mortality in patients with ALF. METHODS: We conducted a population-based study of ALF patients hospitalized between 2009 and 2013 from the Thai Nationwide Hospital Admission database, which comprises 76% of all admissions from 858 hospitals across 77 provinces in Thailand. ALF was diagnosed using ICD-10 codes K72.0 and K71.11. Patients with liver cirrhosis were excluded. RESULTS: There were 20,589 patients diagnosed with ALF during the study period with 12,277 (59.6%) males and mean age of 46.6 ± 20.7 years. The incidence of ALF was 62.9 per million population per year. The most frequent causes of ALF were indeterminate (69.4%), non-acetaminophen drug-induced (26.1%), and viral hepatitis (2.5%). Acetaminophen was the presumptive cause in 1.7% of patients. There were 5502 patients (26.7%) who died within 30 days after admission. One patient (0.005%) underwent liver transplantation. The average hospital stay was 8.7 ± 13.9 days, and the total cost of management was 1075.2 ± 2718.9 USD per admission. The most prevalent complications were acute renal failure (ARF)(24.2%), septicemia (18.2%), and pneumonia (12.3%). The most influential predictive factors for 30-day mortality were ARF (HR = 3.64, 95% CI: 3.43–3.87, p < 0.001), malignant infiltration of the liver (HR = 3.37, 95% CI: 2.94–3.85, p < 0.001), and septicemia (HR = 1.96, 95%CI: 1.84–2.08, p < 0.001). CONCLUSIONS: ALF patients have poor outcomes with 30-day mortality of 26.7% and high economic burden. Indeterminate etiology is the most frequent cause. ARF, malignant infiltration of the liver, and septicemia are main predictors of 30-day mortality.
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spelling pubmed-63486282019-01-31 The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study Thanapirom, Kessarin Treeprasertsuk, Sombat Soonthornworasiri, Ngamphol Poovorawan, Kittiyod Chaiteerakij, Roongruedee Komolmit, Piyawat Phaosawasdi, Kamthorn Pinzani, Massimo BMC Gastroenterol Research Article BACKGROUND: Acute liver failure (ALF) is uncommon but progresses rapidly with high mortality. We investigated the incidence, etiologies, outcomes, and predictive factors for 30-day mortality in patients with ALF. METHODS: We conducted a population-based study of ALF patients hospitalized between 2009 and 2013 from the Thai Nationwide Hospital Admission database, which comprises 76% of all admissions from 858 hospitals across 77 provinces in Thailand. ALF was diagnosed using ICD-10 codes K72.0 and K71.11. Patients with liver cirrhosis were excluded. RESULTS: There were 20,589 patients diagnosed with ALF during the study period with 12,277 (59.6%) males and mean age of 46.6 ± 20.7 years. The incidence of ALF was 62.9 per million population per year. The most frequent causes of ALF were indeterminate (69.4%), non-acetaminophen drug-induced (26.1%), and viral hepatitis (2.5%). Acetaminophen was the presumptive cause in 1.7% of patients. There were 5502 patients (26.7%) who died within 30 days after admission. One patient (0.005%) underwent liver transplantation. The average hospital stay was 8.7 ± 13.9 days, and the total cost of management was 1075.2 ± 2718.9 USD per admission. The most prevalent complications were acute renal failure (ARF)(24.2%), septicemia (18.2%), and pneumonia (12.3%). The most influential predictive factors for 30-day mortality were ARF (HR = 3.64, 95% CI: 3.43–3.87, p < 0.001), malignant infiltration of the liver (HR = 3.37, 95% CI: 2.94–3.85, p < 0.001), and septicemia (HR = 1.96, 95%CI: 1.84–2.08, p < 0.001). CONCLUSIONS: ALF patients have poor outcomes with 30-day mortality of 26.7% and high economic burden. Indeterminate etiology is the most frequent cause. ARF, malignant infiltration of the liver, and septicemia are main predictors of 30-day mortality. BioMed Central 2019-01-28 /pmc/articles/PMC6348628/ /pubmed/30691414 http://dx.doi.org/10.1186/s12876-019-0935-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Thanapirom, Kessarin
Treeprasertsuk, Sombat
Soonthornworasiri, Ngamphol
Poovorawan, Kittiyod
Chaiteerakij, Roongruedee
Komolmit, Piyawat
Phaosawasdi, Kamthorn
Pinzani, Massimo
The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study
title The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study
title_full The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study
title_fullStr The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study
title_full_unstemmed The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study
title_short The incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in Thailand: a population-base study
title_sort incidence, etiologies, outcomes, and predictors of mortality of acute liver failure in thailand: a population-base study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348628/
https://www.ncbi.nlm.nih.gov/pubmed/30691414
http://dx.doi.org/10.1186/s12876-019-0935-y
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