Assessing the effect of N-acetylcysteine in the survival of subjects having acute liver failure

Abstract

Background: Acute liver failure (ALF) is a rare syndrome, characterized by acute derangement of liver function and carries a high mortality. Indeterminate ALF still forms a significant number of cases in India as well as in the world. A prospective case-control study was carried to determine the effect of N-Acetylcysteine (NAC) on the survival of indeterminate ALF patients. Methods: A total of 30 patients with a diagnosis of indeterminate ALF were included in the study. 14 patients received NAC infusion for 72hrs whereas 16 patients in the control group received placebo. The parameters evaluated were demographic, clinical, biochemical, outcome, and length of hospital stay.Results: The two groups were comparable for the various baseline characteristics (demographic, clinical, biochemical, etc.). A total of 18 of 30 (60%) patients died with ALF complications; 6 (42.8%) patients belonged to NAC group and 12 (75%) patients to Control group (P = 0.077). The overall survival was not improved by NAC in indeterminate ALF. The use of NAC also did not reduce the duration of hospital stay of surviving patients (P = 0.409). Conclusion: The overall survival was not improved by NAC in indeterminate ALF. NAC administration did not reduce the dura­tion of hospital stay.