ArticleHepatology international2024
Clinical characteristics and prognosis of non-APAP drug-induced acute liver failure: a large multicenter cohort study.
Article in Hepatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- A Novel Simplified Prognostic Model for 90-day Transplant-free Survival in Patients with Severe Acute Liver Injury/Acute Liver Failure.Journal of clinical and translational hepatology · 2026Article
- Management of acute liver failure-an updated literature review.World journal of critical care medicine · 2025Review
- Alpha-fetoprotein and carbohydrate antigen 19-9 as prognostic biomarkers in acute liver failure: A retrospective study.The Journal of international medical research · 2025Article
- Establishing a predictive nomogram for 21‑day transplant-free survival in drug-induced liver failure.Annals of medicine · 2024Article
- MAFLD and chronic kidney disease: two sides of the same coin?Hepatology international · 2023Article
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Authors and funding
23 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThere is growing recognition of natural history, complications, and outcomes of patients who develop non-acetaminophen (APAP) drug-induced acute liver failure (ALF). To clarify high-risk factors and develop a nomogram model to predict transplant-free survival (TFS) in patients with non-APAP drug-induced ALF.
methodsPatients with non-APAP drug-induced ALF from 5 participating centers were retrospectively analyzed. The primary endpoint was 21-day TFS. Total sample size was 482 patients.
resultsRegarding causative agents, the most common implicated drugs were herbal and dietary supplements (HDS) (57.0%). The hepatocellular type (R ≥ 5) was the main liver injury pattern (69.0%). International normalized ratio, hepatic encephalopathy grades, the use of vasopressor, N-acetylcysteine, or artificial liver support system were associated with TFS and incorporated to construct a nomogram model (drug-induced acute liver failure-5, DIALF-5). The AUROC of DIALF-5 for 7-day, 21-day, 60-day, and 90-day TFS in the internal cohort were 0.886, 0.915, 0.920, and 0.912, respectively. Moreover, the AUROC of DIALF-5 for 21-day TFS had the highest AUROC, which was significantly higher than 0.725 of MELD and 0.519 of KCC (p < 0.05), numerically higher than 0.905 of ALFSG-PI but without statistical difference (p > 0.05). These results were successfully validated in the external cohort (147 patients).
conclusionsBased on easily identifiable clinical data, the novel DIALF-5 model was developed to predict transplant-free survival in non-APAP drug-induced ALF, which was superior to KCC, MELD and had a similar prediction performance to ALFSG-PI but is more convenient, which can directly calculate TFS at multiple time points.
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