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Multicenter Study
. 2013 Nov 22;8(11):e80991.
doi: 10.1371/journal.pone.0080991. eCollection 2013.

Causes and outcomes of acute liver failure in China

Pan Zhao  1 , Chunya Wang, Weiwei Liu, Gang Chen, Xinying Liu, Xi Wang, Bao Wang, Liming Yu, Yanrong Sun, Xiaoming Liang, Haozhen Yang, Fei Zhang
Affiliations
Multicenter Study

Causes and outcomes of acute liver failure in China

Pan Zhao et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(5):e98428

Abstract

Objectives: No extensive investigation has been performed and thus no representative data are available regarding acute liver failure (ALF) in China. This study aims to investigate the causes and outcomes of ALF in China and establish a prognostic model.

Methods: Patients diagnosed as ALF in seven hospitals in different areas of China from January 2007 to December 2012 were retrospectively selected.

Results: Of the 177 patients included in this study, 112 (63.28%) eventually died. The common causes of ALF were drug toxicity (43.50%), indeterminate etiology (29.38%) and acute viral hepatitis (11.30%). Additionally, traditional Chinese herbs predominated in the causes of drug-induced ALF (30/77). No patients in this study received liver transplantation. In the established model for predicting death in ALF, four variables were finally selected out, including age (P=0.01), the entry hepatic encephalopathy grade (P=0.04), international normalized ratio (P<0.01) and arterial blood ammonia (P=0.02). Using a threshold value of 0.5683, this model had a sensitivity of 95.24% and a specificity of 91.30%.

Conclusions: Traditional Chinese medicine was a major cause of ALF in China. The spontaneous mortality of ALF was high, whereas the rate of liver transplantation was significantly low. The established prognostic model of ALF had superior sensitivity and specificity.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Enrollment of patients in this study.
Figure 2
Figure 2. Distribution of causes and outcomes of 177 patients with acute liver failure in China.
Figure 3
Figure 3. Receiver operating characteristic (ROC) curve analysis for the established prognostic model of acute liver failure.
See this image and copyright information in PMC

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