Title: Validation of Early Dynamic Model (EDM) in Predicting the Outcome of Acute Liver Failure (ALF) in a Cohort of Kashmiri Population: A Prospective Study

Authors: Dr Shabir Ahmad Lone, MD, Dr Imtiyaz Ahmad Khan, MD, Dr Ramees Mohi-ud-din Mir, MD

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.73

Abstract

   

Introduction

Acute liver failure is used to describe the development of coagulopathy, usually with an international normalized ratio (INR) of greater than 1.5, and any degree of encephalopathy in a patient without preexisting cirrhosis and with an illness of less than 26 weeks duration. Overall incidence of ALF is 1 - 6 cases per million people every year. ALF accounts for up to 7% of all liver-related deaths 4 and is responsible for 6% of liver transplants.(1-6)

References

  1. Bower W A, Johns M, Margolis H S, Williams I T, Bell B P. Population-based surveillance for acute liver failure. Am J Gastroenterol2007; 102: 2459-63.
  2. Brandsaeter B, Hockerstedt K, Friman S. Fulminant hepatic failure: outcome after listing for highly urgent liver transplantation—12 years experience in the Nordic countries. Liver Transpl2002; 8: 1055–62.
  3. Escorsell A, Mas A. Acute liver failure in Spain: analysis of 267 cases. Liver Transpl2007; 13; 89–95.
  4. Hoofnagle J H, Carithers R L, Shapiro C. Fulminant hepatic failure: summary of a workshop. Hepatology. 1995; 21: 240-252.
  5. Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation; 2007.
  6. Trey C, Davidson C S. The management of fulminant hepatic failure. 1970: 282-298.
  7. Atterbury CE, Maddrey WC, Conn HO. Neomycin-sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy: a controlled, double-blind clinical trial. Am J Dig Dis. 1978;23 (5):398-406.
  8. O’Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet. 1993; 342: 273–275.
  9. O’Grady JG, Williams R. Classification of acute liver failure. Lancet. 1993; 342 (8873): 743.
  10. Ostapowicz G, Fontana R J, Schiodt F V. Results of a prospective    study of acute liver failure at 17 tertiary care centers in the United States. Ann InternMed 2002; 137:947–954.
  11. Khuroo M S, Kamili S. Aetiology and prognostic factors in acuteliver failure in India. J Viral Hepat2003; 10: 224–31.
  12. Acharya SK, Dasarathy S, Kumer TL, et al. Fulminant hepatitis in tropical population: clinical course, cause, and early predictors of outcome. Hepatology 1996; 23:1448-1455.
  13. Tibbs C, Williams R. Viral causes and management of acute liver failure. J Hepatol 1995; 22(Suppl. 1): 68-73.
  14. Fagan EA, Williams R. Fulminant viral hepatitis. Br Med Bull 1990; 46: 462-80.
  15. Bjornsson E, Olsson R. Suspected drug-induced liver fatalities reported to the WHO database. Dig Liver Dis 2006; 38: 33–38.
  16. Wai C-T, Tan B-H, Chan C-L, et al. Drug-induced liver injury at an Asian center: a prospective study. Liver Int 2007; 27: 465–74.
  17. Navarro VJ, Senior JR. Drug-related hepatotoxicity. N Engl J Med 2006; 354: 731–39.
  18. Andrade RJ, Lucena MI, Fernandez MC, et al. Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Gastroenterology 2005; 129: 512–21.
  19. Bjornsson E, Olsson R. Outcome and prognostic markers in severe drug-induced liver disease. Hepatology 2005; 42: 481–89.
  20. Sgro C, Clinard F, Ouazir K, et al. Incidence of drug-induced hepatic injuries: a French population-based study. Hepatology 2002; 36: 451–55.
  21. Bansal J, He J, Yarbough PO. Hepatitis E virus infection in eastern India. Am J Trop Med Hyg 1998; 59: 258-260.
  22. Bernal W. Changing patterns of causation and the use of transplantation in the United Kingdom. Semin Liver Dis 2003; 23: 227–37.
  23. Wei G, Kalaitzakis E, Bergquist A, Bjornsson E. Long-term followup of patients with acute liver failure of indeterminate aetiology. Scand J Gastroenterol 2008; 43: 984–91.
  24. Woolf GM, Redeker AG. Treatment of fulminant hepatic failure with insulin and glucagon: a randomized, controlled trial. Dig Dis Sci 1991; 36:92–96.
  25. Sinclair SB, Greig PD, Blendis LM, Abecassis M, Roberts EA, Phillips MJ, et al. Biochemical and clinical response of fulminant viral hepatitis to administration of prostaglandin E: a preliminary report. J Clin Invest 1989; 84:1063–1069.
  26. O’Grady JG, Gimson AE, O’Brien CJ, Pucknell A, Hughes RD, Williams R. Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure. Gastroent-erology 1988; 94(Pt 1):1186–1192.
  27. Redeker AG, Yamahiro HS. Controlled trial of exchange-transfusion therapy in fulminant hepatitis. Lancet 1973; 1:3–6.
  28. McPhail MJ, Wendon JA, Bernal W. Meta-analysis of performance of King’s College Hospital Criteria in prediction of outcome in nonparacetamol-induced acute liver failure. J Hepatol 2010; 53: 492-499.
  29. O’Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989; 97(2):439-445.
  30.  Malinchoc  M,  Kamath  PS,  Gordon  FD,  Peine  CJ,  Rank  J, ter  Borg  PC.  A  model  to  predict  poor  survival  in  patients undergoing  transjugular  intrahepatic  portosystemic  shunts. Hepatology 2000;31:864-871.
  31. Schmidt LE, Larsen FS. MELD score as a predictor of liver failure  and  death  in  patients  with  acetaminophen induced liver injury. Hepatology 2007;45:789-796.
  32. Yantorno SE, Kremers WK, Ruf AE, Trentadue JJ, et al MELD is superior to King's college and Clichy's criteria to assess prognosis in fulminant hepatic failure. Liver Transpl 2007;13:822-828
  33. Biggins SW, Kim WR, Terrault NA, Saab S, Balan V,  et  al.  Evidence-based  incorporation  of  serum  sodium concentration into MELD. Gastroenterology 2006;130:1652- 1660
  34. Xiol  X,  Gines  P,  Castells  L,  Twose  Riba Fuente Arderiu X, et al. Clinically relevant differencesin the model for  end-stage  liver  disease  and  model  for  end-stage  liver disease. Liver Transpl 2009; 15:300-305
  35. Yantorno SE, Kremers WK, Ruf AE, Trentadue JJ, Podestá Villamil FG. MELD is superior to King's college and Clichy's criteria to assess prognosis in fulminant hepatic failure. Liver Transpl 2007;13:822-82
  36. Zaman MB, Hoti E, Qasim A, et al. MELD score as a prognostic model for listingacute liver failure patients for liver transplantation. Transplant Proc 2006; 38:2097e8.
  37. Katoonizadeh A, Decaestecker J, Wilmer A, et al. MELD score to predict outcomein adult patients with non-acetaminophen-induced acute liver failure. Liver Int2007;27:329e34.
  38. Du WB, Pan XP, Li LJ. Prognostic models for acute liver failure. Hepatobiliary Pancreat Dis Int 2010;9:122e8.
  39. Shakil AO, Kramer D, Mazariegos GV, et al. Acute liver failure: clinical features, outcome analysis, and applicability of prognostic criteria. Liver Transpl 2000; 6:163e9.
  40. Ramesh kumar, Shalimar 2012 Prospective derivation and validation of early dynamic model for predicting outcome in patients with acute liver failure, gut bmj2012).
  41. V Bhatia, R Singh, S K Acharya: Predictive value of arterial ammonia for complications and outcome in acute liver failure. Gut 2006;55:98–104.

Corresponding Author

Dr Imtiyaz Ahmad Khan, MD

Department of Radiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India 190011