Abstract

In acute liver failure, variables favoring survival of patients is based on age, interval between onset of jaundice and encephalopathy, coagulation factor level but all these variables were concluded from the studies that were conducted in Western population where etiology most commonly is paracetamol poisoning and metabolic disorders like Wilson’s disease; where as in Indian subcontinent set up major causative factor is viral hepatitis. Thus we exploited the database collected by observational study to investigate major predictors of survival in viral hepatitis induced acute liver failure. Among 40 patients followed for 1 month(7days) or less if died, there were 12 patients who survived. Tha analysis showed that patients who survived had factor V level on day 3 of diagnosis was in the range of 10%–25% and who died had factor V level below 10% (p<0.004). Thus factor V level on day 3 of diagnosis may help in predicting survival in patients of acute liver failure, thus help in triage for the need of orthotopic liver transplantation which is the only definite curative therapy in patients who have poor survival rates.

t test

outcomeNo. of patientsmeanStandard deviationp valuestandard error of mean
group statistics 
Interval died 26 30.6538 10.8552 <0.002 2.1289 
 survived 14 6.1429 3.3249  0.8886 
FactorV day1 died 26 7.5769 2.8309 >0.05 0.5552 
 survived 14 12.0000 4.3677  1.1673 
Factor VIII day1 died 26 225.3396 156.0354 >0.05 30.6011 
 survived 14 293.3556 206.3757  55.1562 
FactorV day3 died 26 5.9615 2.0096 <0.004 0.3941 
 survived 14 12.9286 4.8272  1.2901 
FactorVIII day3 died 26 248.2509 185.7102 >0.05 36.4208 
 survived 14 274.7226 206.5798  55.2108 
Lactate day1 died 26 74.3308 11.5141 >0.05 2.2581 
 survived 14 59.0929 8.0789  2.1592 
Lactate day3 died 26 78.9500 8.8363 >0.05 1.7329 
 survived 14 62.5000 9.4086  2.5146 
Factor VIII:V day1 died 26 29.8545 16.6385 >0.05 3.2631 
 survived 14 22.9066 8.9435  2.3902 
FActorVIII:V day3 died 26 42.4612 31.8050 <0.003 6.2375 
 survived 14 20.0944 8.7368  2.3350 
pH day1 died 26 7.1365 0.1331 >0.05 2.611E-02 
 survived 14 7.1443 0.1302  2.648E-02 
pH day3 died 26 7.0300 0.1479 >0.05 2.901E-02 
 survived 14 7.2286 0.1075  2.872E-02 
pCO2 day1 died 26 41.8462 7.6036 >0.05 1.4912 
 survived 14 40.7857 7.5261  2.0114 
pCO2 day3 died 26 46.3077 10.3760 >0.05 2.0349 
 survived 14 43.2857 5.8498  1.5634 
pO2 day1 died 26 87.3462 4.3169 >0.05 0.8466 
 survived 14 86.0000 4.3677  1.1673 
pO2 day3 died 26 89.3462 4.0194 >0.05 0.7883 
 survived 14 89.5000 3.6742  0.9820 
outcomeNo. of patientsmeanStandard deviationp valuestandard error of mean
group statistics 
Interval died 26 30.6538 10.8552 <0.002 2.1289 
 survived 14 6.1429 3.3249  0.8886 
FactorV day1 died 26 7.5769 2.8309 >0.05 0.5552 
 survived 14 12.0000 4.3677  1.1673 
Factor VIII day1 died 26 225.3396 156.0354 >0.05 30.6011 
 survived 14 293.3556 206.3757  55.1562 
FactorV day3 died 26 5.9615 2.0096 <0.004 0.3941 
 survived 14 12.9286 4.8272  1.2901 
FactorVIII day3 died 26 248.2509 185.7102 >0.05 36.4208 
 survived 14 274.7226 206.5798  55.2108 
Lactate day1 died 26 74.3308 11.5141 >0.05 2.2581 
 survived 14 59.0929 8.0789  2.1592 
Lactate day3 died 26 78.9500 8.8363 >0.05 1.7329 
 survived 14 62.5000 9.4086  2.5146 
Factor VIII:V day1 died 26 29.8545 16.6385 >0.05 3.2631 
 survived 14 22.9066 8.9435  2.3902 
FActorVIII:V day3 died 26 42.4612 31.8050 <0.003 6.2375 
 survived 14 20.0944 8.7368  2.3350 
pH day1 died 26 7.1365 0.1331 >0.05 2.611E-02 
 survived 14 7.1443 0.1302  2.648E-02 
pH day3 died 26 7.0300 0.1479 >0.05 2.901E-02 
 survived 14 7.2286 0.1075  2.872E-02 
pCO2 day1 died 26 41.8462 7.6036 >0.05 1.4912 
 survived 14 40.7857 7.5261  2.0114 
pCO2 day3 died 26 46.3077 10.3760 >0.05 2.0349 
 survived 14 43.2857 5.8498  1.5634 
pO2 day1 died 26 87.3462 4.3169 >0.05 0.8466 
 survived 14 86.0000 4.3677  1.1673 
pO2 day3 died 26 89.3462 4.0194 >0.05 0.7883 
 survived 14 89.5000 3.6742  0.9820 

Author notes

Disclosure: No relevant conflicts of interest to declare.