ArticleGastroenterology2015
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
Article in Gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 111 citations in OpenAlex.
- Article
- Expanding the boundaries of kidney replacement therapy in patients with liver failure.World journal of critical care medicine · 2025Review
- Acute versus acute-on-chronic liver failure: comparative analysis of clinical outcomes in Beijing, China.BMC gastroenterology · 2025Article
- Ornidazole-Induced Liver Injury: The Clinical Characterization of a Rare Adverse Reaction and Its Implications from a Multicenter Study.Biomedicines · 2025Article
- Asthma Alleviation by Ginsenoside Rb1 via Promotion of Treg Proliferation and Inflammatory T Cell Inhibition.Allergy · 2025Article
- Natural History of Idiosyncratic Drug-Induced Liver Injury and Prognostic Models.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Challenges in herbal-induced liver injury identification and prevention.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Trends in Liver Transplantation for Acute Liver Failure in a Spanish Multicenter Cohort.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- Mesenchymal stromal cells alleviate APAP-induced liver injury via extracellular vesicle-mediated regulation of the miR-186-5p/CXCL1 axis.Stem cell research & therapy · 2024Article
- [Drug-induced autoimmune-like liver injury].Innere Medizin (Heidelberg, Germany) · 2024Review
- Liver injury from direct oral anticoagulants.World journal of hepatology · 2023Article
- [Significance of histological assessment in drug-induced liver injury].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Article
- Review
- Challenges and Future of Drug-Induced Liver Injury Research-Laboratory Tests.International journal of molecular sciences · 2022Review
- The determination of causality of drug induced liver injury in patients with COVID-19 clinical syndrome.PloS one · 2022Article
- dialogi: Utilising NLP With Chemical and Disease Similarities to Drive the Identification of Drug-Induced Liver Injury Literature.Frontiers in genetics · 2022Article
- Disruption of peroxisome proliferator-activated receptor α in hepatocytes protects against acetaminophen-induced liver injury by activating the IL-6/STAT3 pathway.International journal of biological sciences · 2022Article
- Acute (fulminant) liver failure: a clinical and imaging review.Abdominal radiology (New York) · 2021Review
- In Vitro Liver Toxicity Testing of Chemicals: A Pragmatic Approach.International journal of molecular sciences · 2021Review
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsMedications are a major cause of acute liver failure (ALF) in the United States, but no population-based studies have evaluated the incidence of ALF from drug-induced liver injury. We aimed to determine the incidence and outcomes of drug-induced ALF in an integrated health care system that approximates a population-based cohort.
methodsWe performed a retrospective cohort study using data from the Kaiser Permanente Northern California (KPNC) health care system between January 1, 2004, and December 31, 2010. We included all KPNC members age 18 years and older with 6 months or more of membership and hospitalization for potential ALF. The primary outcome was drug-induced ALF (defined as coagulopathy and hepatic encephalopathy without underlying chronic liver disease), determined by hepatologists who reviewed medical records of all KPNC members with inpatient diagnostic and laboratory criteria suggesting potential ALF.
resultsAmong 5,484,224 KPNC members between 2004 and 2010, 669 had inpatient diagnostic and laboratory criteria indicating potential ALF. After medical record review, 62 (9.3%) were categorized as having definite or possible ALF, and 32 (51.6%) had a drug-induced etiology (27 definite, 5 possible). Acetaminophen was implicated in 18 events (56.3%), dietary/herbal supplements in 6 events (18.8%), antimicrobials in 2 events (6.3%), and miscellaneous medications in 6 events (18.8%). One patient with acetaminophen-induced ALF died (5.6%; 0.06 events/1,000,000 person-years) compared with 3 patients with non-acetaminophen-induced ALF (21.4%; 0.18/1,000,000 person-years). Overall, 6 patients (18.8%) underwent liver transplantation, and 22 patients (68.8%) were discharged without transplantation. The incidence rates of any definite drug-induced ALF and acetaminophen-induced ALF were 1.61 events/1,000,000 person-years (95% confidence interval, 1.06-2.35) and 1.02 events/1,000,000 person-years (95% confidence interval, 0.59-1.63), respectively.
conclusionsDrug-induced ALF is uncommon, but over-the-counter products and dietary/herbal supplements are its most common causes.
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