ACUTE HEPATIC NECROSIS WITH STUPOR OR COMA An Analysis of Thiety-One Patients

Ritt, Donald J.; Whelan, Gregory; Werner, David J.; Eigenbrodt, Edwin H.; Schenker, Steven; Combes, Burton

doi:10.1097/00005792-196903000-00003

Cited by 140 publications

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“…The three largest published series from the United States included 31, 34, and 62 patients and reported mortality rates of 97%, 94%, and 82%, respectively. [2][3][4] Hepatitis B and non A non B hepatitis were the most frequent identifiable causes of ALF in these earlier studies, which are now more than 20 years old. Accordingly, there is a shortage of reliable current data from the United States concerning this syndrome.…”

confidence: 75%

Etiology and outcome for 295 patients with acute liver failure in the united states

et al. 1999

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Little information is available on acute liver failure (ALF) in the United States. We gathered demographic data retrospectively for a 2-year period from July 1994 to June 1996 on all cases of ALF from 13 hospitals (12 liver transplant centers). Data on the patients included age, hepatic coma grade on admission, presumed cause, transplantation, and outcome. Among 295 patients, 74 (25%) survived spontaneously, 121 (41%) underwent transplantation, and 99 (34%) died without undergoing transplantation. Ninety-two of 121 patients (76%) survived 1 year after transplantation. Acetaminophen overdose was the most frequent cause (60 patients; 20%), followed by cryptogenic/non A non B non C (NANBNC; 15%), idiosyncratic drug reactions (12%), hepatitis B (10%), and hepatitis A (7%). Spontaneous survival rates were highest for patients with acetaminophen overdose (57%) and hepatitis A (40%) and lowest for those with Wilson's disease (no survivors of 18 patients). The transplantation rate was highest for Wilson's disease (17 of 18 patients; 94%) and lowest for autoimmune hepatitis (29%) and acetaminophen overdose (12%). Age did not differ between survivors and nonsurvivors, perhaps reflecting a selection bias for patients transferred to liver transplant centers. Coma grade on admission was not a significant determinant of outcome, but showed a trend toward affecting both survival and transplantation rate. These findings on retrospectively studied patients from the United States differ from those previously gathered in the United Kingdom and France, highlighting the need for further study of trends in each country.

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confidence: 75%

Etiology and outcome for 295 patients with acute liver failure in the united states

et al. 1999

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“…Nevertheless, not all patients with acute liver failure should undergo transplantation, or at least not too quickly. Previous reported spontaneous (transplantation-free) survival rates of less than 10% 11,12 are no longer valid. It is possible that better intensive care monitoring and/or a change of etiologic pattern has changed the natural course of acute liver failure.…”

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confidence: 87%

Liver transplantation for acute liver failure-Better safe than sorry

Schiødt

Lee

2002

Liver Transpl

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“…58 The diagnosis of hepatic ischemic damage is usually easy in the typical clinical setting and with the characteristic laboratory findings just described. 52,53 On occasion, the clinical picture of liver injury and even liver failure overshadow the cause of hepatic ischemia, and patients may present in a fulminant fashion, [59][60][61][62] even without apparent cardiac dysfunction. 63 More than a Century ago, Victor Charles Hanot coined the colorful term "hepatic asystole" for cases in which the hepatic disease eclipses the primary cardiac disorder.…”

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confidence: 99%

You've Gotta Have Heart! *

Reuben

2005

Hepatology

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ACUTE HEPATIC NECROSIS WITH STUPOR OR COMA An Analysis of Thiety-One Patients

Cited by 140 publications

References 0 publications

Etiology and outcome for 295 patients with acute liver failure in the united states

Etiology and outcome for 295 patients with acute liver failure in the united states

Liver transplantation for acute liver failure-Better safe than sorry

You've Gotta Have Heart! *

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