The etiology and factors related to the outcome of children with acute liver failure

Abstract

Objective To investigate the fundamental etiology and factors related to the outcome of children with acute liver failure in recent years. Methods The etiology and factors related to the outcome of pediatric acute liver failure(PALF) patients who hospitalized in Department of Pediatric Intensive Care Unit, Beijing Children′s Hospital, Capital Medical University from August 2007 to July 2017 were retrospectively analyzed. Results (1)Of 92 children with PALF, there were 47 males and 45 females.(2)The incidence was particularly high in Summer.Morbidity was the highest in infants(38.0%, 35/92 cases), and it was not uncommon in ≤3 year-old children(23.9%, 22/92 cases). (3)Etiology diagnosis was not established in 38 children(41.3%, 38/92 cases). Etiology diagnosis could be established in infectious disease(16.3%, 15/92 cases), metabolic disease(8.7%, 8/92 cases)and mushroom poisoning(7.6%, 7/92 cases). The etiology of PALF was significantly related to age.(4)Twenty-nine cases survived and the survival rate was 31.5%, invalid 63 cases(68.5%, 63/92 cases), of which 14 cases(22.2%, 14/63 cases)died, 49 cases(77.8%, 49/63 cases) gave up treatment or left the hospital by themselves.(5)It showed that the factors significantly correlated with the outcome of PALF were respiratory failure, albumin(ALB), and the peak of total bilirubin (TBIL)(P=0.013, 0.029, 0.002). Conclusions The outcome of PALF is poor and the survival rate is still low.Morbidity is the highest in infants, and the incidence is particularly high in Summer.Infectious disease is the commonest etiology in children compared with metabolic disease and mushroom poisoning.Its pathogen is still unknown.The etiology of PALF is significantly related to age, respiratory failure, ALB, and the peak of TBIL during hospitalization was the relevant factors for PALF prognosis in this study. Key words: Acute liver failure; Retrospective research; Etiology; Outcome; Child