Analysis of risk factors for mortality in patients with mushroom poisoning-induced hepatic failure

Hepatic failure induced by wild mushroom poisoning often leads to fatality. There still lacks a definitive effective treatment. Liver transplantation has become the last resort for treatment. This study aims to compare indicators between survivors and non-survivors of mushroom poisoning-induced hepatic failure, identify risk factors for mortality among them, and early identify who may require liver transplantation, with the goal of enhancing survival rates.

We collected data from 34 patients with mushroom poisoning-induced hepatic failure admitted to our emergency department between January 2008 and December 2018. Patients were categorized into two groups based on their outcomes at 21 days, and clinical indicators between two groups were analyzed for significant differences. Clinical factors correlated with hepatic failure were subjected to COX regression to identify factors associated with mortality, and ROC curve analysis was employed to compute precise diagnostic indices of these risk factors in clinical rescue scenarios.

The non-survival group exhibited shorter hospital stays, higher PTmax (maximum prothrombin time), INRmax (maximum international normalized ratio), NH₃max (maximum plasma ammonia levels), and lower Hbmin(minimum hemoglobin levels). In the COX regression analysis, we found that the staging of hepatic encephalopathy, INRmax, PTmax, and ASTd (days of highest aspartate aminotransferase levels) were associated with mortality.

For patients with liver failure due to mushroom poisoning, it is necessary to closely monitor the stage of hepatic encephalopathy, INR, PT and AST changes during treatment. These are risk factors for their death, and liver transplantation should be considered as early as possible.