主题：【原创】悲观看中医——从发展的角度 -- sarn

Causes and Outcomes of Acute Liver Failure in China

Pan Zhao, Chunya Wang, Weiwei Liu, Gang Chen, Xinying Liu, Xi Wang, Bao Wang, Liming Yu, Yanrong Sun, Xiaoming Liang, Haozhen Yang, Fei Zhang

1 Liver Failure Therapy and Research Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing, China, 2 Emergency Department, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China, 3 Postgraduate Division, Academy of Military Medical Science, Beijing, China, 4 Disease Prevention and Control Office, Second Artillery Force of PLA, Beijing, China, 5 Western and Traditional Chinese Medicine Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing, China, 6 Medical Administration Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China, 7 Medical Administration Department, PLA 477 Hospital, Wuhan, Hubei Province, China, 8 Medical Administration Department, General Hospital of Jinan Military Region, Jinan, Shandong Province, China, 9 Medical Administration Department, General Hospital of Lanzhou Military Region, Lanzhou, Gansu Province, China, 10 Gastroenterology Department, PLA 161 Hospital, Wuhan, Hubei Province, China, 11 Intensive Care Unit, General Hospital of PLA, Beijing, China

Published: November 22, 2013

Abstract

Objectives: No extensive investigation has been performed and thus no representative data are available regarding acute liver failure (ALF) in China. This study aims to investigate the causes and outcomes of ALF in China and establish a prognostic model.

Methods: Patients diagnosed as ALF in seven hospitals in different areas of China from January 2007 to December 2012 were retrospectively selected.

Results: Of the 177 patients included in this study, 112 (63.28%) eventually died. The common causes of ALF were drug toxicity (43.50%), indeterminate etiology (29.38%) and acute viral hepatitis (11.30%). Additionally, traditional Chinese herbs predominated in the causes of drug-induced ALF (30/77). No patients in this study received liver transplantation. In the established model for predicting death in ALF, four variables were finally selected out, including age (P=0.01), the entry hepatic encephalopathy grade (P=0.04), international normalized ratio (P<0.01) and arterial blood ammonia (P=0.02). Using a threshold value of 0.5683, this model had a sensitivity of 95.24% and a specificity of 91.30%.

Conclusions: Traditional Chinese medicine was a major cause of ALF in China. The spontaneous mortality of ALF was high, whereas the rate of liver transplantation was significantly low. The established prognostic model of ALF had superior sensitivity and specificity.

DOI: 10.1371/journal.pone.0080991