Evidence map›Paper›PMID 41270879›Full record

Observational studyClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2026

The DILI-Inpt Prognostic Score to Identify Hospitalized Idiosyncratic DILI Patients at Risk for Adverse Outcomes.

Alisa Likhitsup, Zemin Su, Jody A Rule, Ahmad Anouti, Ashwin Rao, Hoss Rostami, Valerie Durkalski-Mauldin, William M Lee, Robert J Fontana

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00518440 (A Multi-Center Trial to Study Acute Liver Failure in Adults), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00518440 completednot on this map

A Multi-Center Trial to Study Acute Liver Failure in Adults

TypeobservationalSponsorWilliam LeeRan1998 to 2019Enrolled3,488ConditionsAcute Liver Failure, Fulminant Hepatic Failure, Acute Liver Injury
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. [Research progress in the field of drug-induced liver injury in 2025].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alisa LikhitsupDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
Zemin SuDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
Jody A RuleDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Ahmad AnoutiDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Ashwin RaoDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Hoss RostamiDuke Clinical Research Institute, Raleigh, North Carolina.
Valerie Durkalski-MauldinDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
William M LeeDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Robert J FontanaDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan. Electronic address: rfontana@med.umich.edu.

Funding

A Multi-Center Study of Acute Liver Failure in AdultsU01DK058369 · NIDDK · UT SOUTHWESTERN MEDICAL CENTER · PI DURKALSKI, VALERIE L, FONTANA, ROBERT J · 2005 to 2019
$27.4M
Michigan Hepatotoxicity Clinical Research Network Renewal 2018U01DK065184 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ROBERT J FONTANA · 2003 to 2026
$7.0M
NIDDK NIH HHS U01 DK058369NIDDK NIH HHS U01 DK065184
6 · The paper itself

Abstract

BACKGROUND &

aimsAcute liver failure (ALF) due to idiosyncratic drug-induced liver injury (DILI) has a poor prognosis. We set out to identify presenting features associated with nonspontaneous survival in hospitalized patients with severe idiosyncratic DILI.

methodsA total of 305 adult ALFSG (Acute Liver Failure Study Group) registry participants from January 1998 to August 2019 had acute liver injury (ALI) (ie, international normalized ratio >2.0 without encephalopathy) or ALF attributed to DILI. A multivariable model was developed to predict 21-day outcome (death or liver transplantation) using admission data and was compared with the Model for End-Stage Liver Disease (MELD) and King's College Criteria scores.

resultsA total of 44 DILI patients had ALI and 261 had ALF. The median age was 44 years, 67% were female, and the median MELD score was 32 (range 14-54). Suspect agents included antimicrobials (42.6%), herbal-dietary supplements (16%), and psychoactive drugs (9.8%). At 21 days, 110 (36%) were spontaneous survivors and 195 (64%) were nonspontaneous survivors, including 115 that required liver transplantation and 80 who died. The DILI inpatient score (consisting of total bilirubin, INR, encephalopathy grade, and herbal and dietary supplement products) had an area under the receiver-operating characteristic curve (AUROC) of 0.86 (95% confidene interval, 0.82-0.91) for 21-day nonspontaneous survival that was superior to the MELD (AUROC 0.86 vs 0.79; P = .008) and King's College Criteria (AUROC 0.86 vs 0.63; P < .001) scores.

conclusionsThe new DILI inpatient prognostic score identified patients with the lowest likelihood of spontaneous survival. This simple prognostic score may be a useful guide for medical decision making in hospitalized DILI patients if confirmed in other cohorts. CLINICALTRIALS: gov, Number: NCT00518440.

Indexed as

Chemical and Drug Induced Liver InjuryLiver Failure, AcuteAdolescentAdultFemaleHospitalizationHumansLiver TransplantationMaleMiddle AgedPrognosisRegistriesSeverity of Illness IndexYoung AdultAcute Liver FailureDiver TransplantationDrug HepatotoxicityPrognostic Index

Identifiers

PMID41270879
PMCPMC13461135

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.