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.
■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。