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Abstract：
UNASSIGNED: Acute liver failure (ALF) is rare and associated with poor outcomes. The outcomes of ALF and predictors of outcome may vary as per the etiology. There are limited data on the predictors of spontaneous survival among patients with ALF of non-A-E hepatitis or cryptogenic etiology. We aimed to assess clinical course, complications, and outcome of non-A-E etiology ALF.
UNASSIGNED: In this prospective analysis, all consecutive ALF patients (n = 1555; January 1986-June 2018) were analyzed. Non-A-E-ALF was defined as ALF that could not be attributed to known etiologies such as drugs, viral hepatitis, autoimmune hepatitis, and Wilson\'s disease. Clinical course, complications, and outcomes of non-A-E-ALF patients who did not undergo liver transplantation were analyzed. Unadjusted and adjusted odds ratios (ORs) were calculated.
UNASSIGNED: Non-A-E-ALF constituted 34.6% (n = 538) of all ALF patients, whereas hepatitis E virus (HEV), hepatitis B virus (HBV), and anti-tuberculosis therapy (ATT) accounted for 29.5% (n = 459), 8.6% (n = 134), and 7.4% (n = 115), respectively. Among non-A-E-ALF patients, mean age was 28.8 ± 12.0 years, 50.9% females, majority (63.1%) had hyperacute presentation, and 79.2% had advanced encephalopathy at presentation. The frequency of cerebral edema in non-A-E-ALF (53.3%) was higher than that in HEV-ALF (41.2%) and ATT-ALF (44.2%), P < 0.001. The survival rate in non-A-E-ALF (37.5%) was poorer than HEV-ALF (54.9%) and was comparable to that in HBV (35.8%) and ATT (29.6%) induced ALF. The baseline prothrombin time prolongation (odds ratio [OR] 1.041; 95% confidence intervals [CI], 1.017-1.065) and infection (OR 2.366; 95%CI, 1.107-5.055) were independent predictors of outcome in non-A-E-ALF. The 3-days acute liver failure early dynamic model had the best value in predicting the outcome.
UNASSIGNED: Non-A-E-ALF accounts for one-third of all cases of ALF and is associated with poor spontaneous survival.
UNASSIGNED: In this prospective analysis, all consecutive ALF patients (n = 1555; January 1986-June 2018) were analyzed. Non-A-E-ALF was defined as ALF that could not be attributed to known etiologies such as drugs, viral hepatitis, autoimmune hepatitis, and Wilson\'s disease. Clinical course, complications, and outcomes of non-A-E-ALF patients who did not undergo liver transplantation were analyzed. Unadjusted and adjusted odds ratios (ORs) were calculated.
UNASSIGNED: Non-A-E-ALF constituted 34.6% (n = 538) of all ALF patients, whereas hepatitis E virus (HEV), hepatitis B virus (HBV), and anti-tuberculosis therapy (ATT) accounted for 29.5% (n = 459), 8.6% (n = 134), and 7.4% (n = 115), respectively. Among non-A-E-ALF patients, mean age was 28.8 ± 12.0 years, 50.9% females, majority (63.1%) had hyperacute presentation, and 79.2% had advanced encephalopathy at presentation. The frequency of cerebral edema in non-A-E-ALF (53.3%) was higher than that in HEV-ALF (41.2%) and ATT-ALF (44.2%), P < 0.001. The survival rate in non-A-E-ALF (37.5%) was poorer than HEV-ALF (54.9%) and was comparable to that in HBV (35.8%) and ATT (29.6%) induced ALF. The baseline prothrombin time prolongation (odds ratio [OR] 1.041; 95% confidence intervals [CI], 1.017-1.065) and infection (OR 2.366; 95%CI, 1.107-5.055) were independent predictors of outcome in non-A-E-ALF. The 3-days acute liver failure early dynamic model had the best value in predicting the outcome.
UNASSIGNED: Non-A-E-ALF accounts for one-third of all cases of ALF and is associated with poor spontaneous survival.
摘要：
■急性肝衰竭（ALF）罕见且与不良预后相关。ALF的结果和结果的预测因子可能因病因而异。关于非A-E型肝炎或隐源性病因的ALF患者的自发生存预测因素的数据有限。我们的目的是评估临床过程，并发症,和非A-E病因ALF的结果。
■在这项前瞻性分析中，对所有连续ALF患者(n=1555;1986年1月至2018年6月)进行分析.非A-E-ALF被定义为不能归因于已知病因如药物的ALF。病毒性肝炎,自身免疫性肝炎，和威尔逊的病。临床课程，并发症,并分析未接受肝移植的非A-E-ALF患者的结局.计算未调整和调整后的比值比(ORs)。
■非A-E-ALF占所有ALF患者的34.6％（n=538），而戊型肝炎病毒（HEV），乙型肝炎病毒（HBV），抗结核治疗（ATT）占29.5%（n=459），8.6%(n=134)，和7.4%(n=115)，分别。在非A-E-ALF患者中，平均年龄28.8±12.0岁,50.9%女性，大多数（63.1%）有超急性表现，79.2%出现晚期脑病。非A-E-ALF脑水肿发生率(53.3%)高于HEV-ALF(41.2%)和ATT-ALF(44.2%),P<0.001。非A-E-ALF的生存率（37.5％）低于HEV-ALF（54.9％），与HBV（35.8％）和ATT（29.6％）诱导的ALF相当。基线凝血酶原时间延长(比值比[OR]1.041；95%置信区间[CI]，1.017-1.065）和感染（OR2.366;95CI，1.107-5.055）是非A-E-ALF结局的独立预测因子。3天急性肝衰竭早期动态模型对预后的预测价值最好。
■非A-E-ALF占所有ALF病例的三分之一，与自发生存率差相关。
■在这项前瞻性分析中，对所有连续ALF患者(n=1555;1986年1月至2018年6月)进行分析.非A-E-ALF被定义为不能归因于已知病因如药物的ALF。病毒性肝炎,自身免疫性肝炎，和威尔逊的病。临床课程，并发症,并分析未接受肝移植的非A-E-ALF患者的结局.计算未调整和调整后的比值比(ORs)。
■非A-E-ALF占所有ALF患者的34.6％（n=538），而戊型肝炎病毒（HEV），乙型肝炎病毒（HBV），抗结核治疗（ATT）占29.5%（n=459），8.6%(n=134)，和7.4%(n=115)，分别。在非A-E-ALF患者中，平均年龄28.8±12.0岁,50.9%女性，大多数（63.1%）有超急性表现，79.2%出现晚期脑病。非A-E-ALF脑水肿发生率(53.3%)高于HEV-ALF(41.2%)和ATT-ALF(44.2%),P<0.001。非A-E-ALF的生存率（37.5％）低于HEV-ALF（54.9％），与HBV（35.8％）和ATT（29.6％）诱导的ALF相当。基线凝血酶原时间延长(比值比[OR]1.041；95%置信区间[CI]，1.017-1.065）和感染（OR2.366;95CI，1.107-5.055）是非A-E-ALF结局的独立预测因子。3天急性肝衰竭早期动态模型对预后的预测价值最好。
■非A-E-ALF占所有ALF病例的三分之一，与自发生存率差相关。
