ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2021
Clinical and Neurologic Outcomes in Acetaminophen-Induced Acute Liver Failure: A 21-Year Multicenter Cohort Study.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 38 citations in OpenAlex.
- Non-invasive intracranial pressure estimation in the intensive care unit: narrative review of methods and clinical applications.Intensive care medicine · 2026Review
- Acetaminophen toxicity: Patterns of liver injury, effects on hospital length of stay, and the need for inpatient psychiatric care.Hepatology forum · 2026Article
- Dynamic nomogram predicts sepsis risk in patients with acute liver failure: Analysis of intensive care database with external validation.World journal of gastroenterology · 2025Article
- Effect of plasma adsorption and low-volume plasma exchange on intracranial pressure in acute-on-chronic liver failure: a prospective observational study.BMC gastroenterology · 2025Observational
- Brain CT Scan Diagnostic and Prognostic Value in Patients With Acute Liver Failure and Cerebral Edema: A Multicenter Cohort Study.Critical care explorations · 2025Article
- Association between volume of processed plasma and total bilirubin reduction during plasma adsorption for severe liver disease.European journal of medical research · 2025Observational
- Natural Polyphenol-Mediated Inhibition of Ferroptosis Alleviates Oxidative Damage and Inflammation in Acute Liver Injury.Biomaterials research · 2025Article
- Acute liver failure: A practical update.JHEP reports : innovation in hepatology · 2024Review
- Clinical characteristics and prognosis of non-APAP drug-induced acute liver failure: a large multicenter cohort study.Hepatology international · 2024Article
- Outcome of patients with different stages of acute-on-chronic liver failure treated with artificial liver support system.Frontiers in medicine · 2024Article
- [Research progress of non-biological artificial liver support system therapy for paitents with liver failure].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Article
- Persistent But Not Transient Acute Kidney Injury Was Associated With Lower Transplant-Free Survival in Patients With Acute Liver Failure: A Multicenter Cohort Study.Critical care medicine · 2022Article
- Management of Acute Liver Failure: Update 2022.Seminars in liver disease · 2022Article
- Adverse Events and Outcomes of High-volume Plasma Exchange in 50 Acute Liver Failure Patients: A Monocentric Retrospective Real-world Study.Journal of clinical and experimental hepatologyArticle
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Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsAcetaminophen (APAP)-induced acute liver failure (ALF) is a rare disease associated with high mortality rates. This study aimed to evaluate changes in interventions, psychosocial profile, and clinical outcomes over a 21-year period using data from the ALF Study Group registry.
methodsA retrospective review of this prospective, multicenter cohort study of all APAP-ALF patients enrolled during the study period (1998-2018) was completed. Primary outcomes evaluated were the 21-day transplant-free survival (TFS) and neurologic complications. Covariates evaluated included enrollment cohort (early, 1998-2007; recent, 2008-2018), intentionality, psychiatric comorbidity, and use of organ support including continuous renal replacement therapy (CRRT).
resultsOf 1190 APAP-ALF patients, recent cohort patients (n = 608) had significantly improved TFS (recent, 69.8% vs early, 61.7%; P = .005). Recent cohort patients were more likely to receive CRRT (22.2% vs 7.6%; P < .001), and less likely to develop intracranial hypertension (29.9% vs 51.5%; P < .001) or die by day 21 from cerebral edema (4.5% vs 11.6%; P < .001). Grouped by TFS status (non-TFS, n = 365 vs TFS, n = 704), there were no differences in psychiatric comorbidity (51.5% vs 55.0%; P = .28) or intentionality (intentional, 39.7% vs 41.6%; P = .58). On multivariable logistic regression adjusting for vasopressor support, development of grade 3/4 hepatic encephalopathy, King's College criteria, and MELD score, the use of CRRT (odds ratio, 1.62; P = .023) was associated with significantly increased TFS (c-statistic, 0.86). In a second model adjusting for the same covariates, recent enrollment was associated significantly with TFS (odds ratio, 1.42; P = .034; c-statistic, 0.86).
conclusionsTFS in APAP-ALF has improved in recent years and rates of intracranial hypertension/cerebral edema have decreased, possibly related to increased CRRT use.
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