Assessment of Prognostic Factors of Acute Hepatitis Among Pediatric Patients: A Cross-Sectional Study
Neda Ezoddin1, Fateme Ziamanesh1, Alireza Ramandi2,3
1Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center Tehran University of Medical Sciences Tehran Iran.
Insights
Identifying prognostic factors for acute hepatitis in children is key for better outcomes. Low albumin, prolonged PT, high INR, encephalopathy, low phosphorus, and delayed hospitalization increase mortality risk.
Area of Science:
- Pediatric Hepatology
- Gastroenterology
- Clinical Pediatrics
Background:
- Early identification and management of acute hepatitis in children are vital for reducing severe outcomes.
- Understanding prognostic factors aids in timely intervention and improved patient prognosis.
Purpose of the Study:
- To investigate the key prognostic factors associated with acute hepatitis in pediatric patients.
- To identify indicators that predict mortality or the need for liver transplantation.
Main Methods:
- A cross-sectional study involving 164 children diagnosed with acute hepatitis.
- Data collected from March 2018 to March 2023, analyzed using SPSS statistical software.
Main Results:
- Viral infections were the most common cause, prevalent in patients without acute liver failure.
- Wilson's disease was more common in patients with acute liver failure, with significant transplantation and mortality rates.
- Low albumin, prolonged prothrombin time (PT), elevated international normalized ratio (INR), encephalopathy, low phosphorus, and delayed hospitalization were linked to worse outcomes.
Conclusions:
- Albumin levels, PT, INR, encephalopathy, phosphorus levels, and symptom-to-hospitalization duration are significant prognostic indicators.
- These factors are crucial for assessing the risk of mortality or transplantation in pediatric acute hepatitis.
Introduction:
Early identification of acute hepatitis etiology and specific management is crucial for reducing morbidity and mortality. Therefore, this study aims to investigate the prognostic factors of acute hepatitis in children.
Methods:
This cross-sectional study was conducted on children with diagnosis of acute hepatitis According to the criteria of ESPHAGAN, admitted to the Children's Hospital from March 2018 to March 2023. Data were analyzed using SPSS statistical software.
Results:
A total of 164 patients with acute hepatitis were included, comprising 78 patients with acute liver failure and 86 patients without acute liver failure. Viral infections were identified as the most common etiology of acute hepatitis and were significantly more prevalent in patients without acute liver failure. Wilson's disease was significantly more prevalent in patients with acute liver failure. All patients with viral etiology recovered. Among the 24 patients with Wilson's disease, 14 (58.3%) underwent transplantation, 4 (16.6%) were deceased, and 6 (25%) survived without transplantation. Patients with other etiologies did not experience any mortality, with only 13.8% undergoing transplantation due to autoimmune causes. Low albumin (< 2.5), prolonged PT (> 22), elevated INR (> 3), encephalopathy, low phosphorus (< 3), and a duration of more than 7 days between symptom onset and hospitalization significantly increased the risk of mortality or need for transplantation in patients with acute liver disease.
Conclusion:
Albumin levels, PT, INR, encephalopathy, phosphorus levels, and the duration between symptom onset and hospitalization are significant prognostic factors for acute hepatitis in pediatric patients.
