Acute liver failure. Experience with 145 patients.

Area of Science:

• Hepatology
• Critical Care Medicine
• Viral Hepatitis

Background:

• Acute liver failure (ALF) is a rare but critical condition with significant mortality.
• Viral hepatitis is a primary cause of ALF, particularly in younger populations.
• Pregnancy in women of reproductive age with ALF requires careful prognostic consideration.

Purpose of the Study:

• To analyze outcomes of a large cohort of ALF patients managed with a simple intensive supportive therapy.
• To identify prognostic factors influencing survival in ALF.
• To compare the efficacy of supportive therapy with complex regimens.

Main Methods:

• Retrospective analysis of 145 ALF patients admitted between July 1976 and December 1981.
• Data collection included demographics, clinical presentation, complications, and treatment outcomes.
• Statistical analysis to determine survival rates and identify prognostic indicators.

Main Results:

• Overall survival rate was 28.9%, with higher survival (33%) in patients under 40.
• Cerebral edema and bleeding were the most frequent complications.
• Prognosis was linked to coma grade, with Grade I having 62% survival and Grade IV having 22.8% survival.
• HBsAg presence, high bilirubin, and low serum sodium indicated poor prognosis.

Conclusions:

• A simple intensive supportive therapy regimen can achieve outcomes comparable to complex treatments for ALF.
• Age, coma grade, and specific biochemical markers are crucial prognostic indicators.
• Pregnancy did not negatively impact survival in ALF patients.