ArticleWorld journal of critical care medicine2025
Acute liver failure etiology, clinical manifestation and outcomes in adults: Experience of tertiary care hospital in Karachi.
Article in World journal of critical care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMany causal factors influence acute liver failure (ALF), including the primary underlying cause, age, and socioeconomic conditions. ALF outcomes depend on etiology, coagulopathy, bilirubin, age, and understanding of hepatic encephalopathy (HE), and help us predict coma and death.
aimTo evaluate the association between etiologies, clinical manifestations, and outcomes of adults admitted with ALF.
methodsThis institution-based, prospective cross-sectional study was conducted in the Department of Gastroenterology and Hepatology at Jinnah Postgraduate Medical Center, Karachi, from July 2019 to December 2022. A total of 102 patients diagnosed with ALF were included using consecutive sampling and data were collected from patients who visited Jinnah Postgraduate Medical Center, Karachi, the gastroenterology and hepatology department, entered into Microsoft Excel, and analyzed using Statistical Package for the Social Sciences version 26.0. Diagnosis was based on King's College criteria: Age, encephalopathy grade, bilirubin, prothrombin time, international normalized ratio, creatinine, and etiology. We assessed the association between socioeconomic status and various outcomes using chi-square tests with a level of significance was less than 0.05.
resultsMean age of the ALF cohort was 27.37 ± 6.60 years. Of the 102 patients, 71 (69.6%) were female, including 55 (77.5%) pregnant women with a mean gestational age of 34.56 ± 3.80 weeks. Regarding HE severity, 45 (44.1%) had grade III, and 13 (12.7%) had grade II. Among the patients admitted to the intensive care unit, 51 (72.9%) did not survive, while 14 (43.8%) recovered.
conclusionThis study observed a high mortality rate among ALF patients in a tertiary care hospital. Hepatitis E virus infection, HE severity, and sepsis were significantly associated with higher mortality.
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