CLIF-OF >9 predicts poor outcome in patients with Amanita phalloides poisoning.

Abstract

Amanita phalloides poisoning with high mortality is rare but serious. The aim of this study is to identify the risk indicators of death in patients with Amanita phalloides poisoning and a good score tool to predict prognosis. In this respective study (1/2009-12/2018), the patients (n=105) with Amanita phalloides poisoning from two hospitals of China Medical University who met the inclusion/exclusion criteria were included. The laboratory markers and the clinical scoring systems including Child-Turcotte-Pugh (CTP), Sequential organ failure assessment (SOFA), Liver injury and Failure evaluation (LiFe), Chronic liver failure-organ failure score system (CLIF-OF), King's College criteria (KCH criteria), Model for end-stage liver disease (MELD) and Platelet-bilirubin-albumin (PALBI) within 24h of admission to the two hospitals were analyzed and area under the curve (AUC) analyses were also performed regarding the prediction of death. The data analysis indicated that high international normalized ratio (INR) (>3.6, AUC=0.941) and plasma ammonia (>95.1μmol/L, AUC=0.805) were closely associated with mortality after multivariate logistic regression. CLIF-OF (>9) within 24h with really good diagnostic accuracy (>90%) significantly outperformed the other scores in predicting mortality. CLIF-OF (>9) within 24h of admission is considered as a satisfactory and practical tool to predict a poor outcome of Amanita phalloides poisoning.