Acetaminophen induced acute liver failure with improving liver biochemistry but worsening cerebral edema: when the king’s college criteria do not help you

2017 ◽  
Vol 2 ◽  
pp. 73-73
Author(s):  
Ahmed Kayal ◽  
Vladimir Marquez-Azalgara ◽  
Siegfried R. Erb ◽  
Charles H. Scudamore ◽  
Eric M. Yoshida
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
King's College ◽  
King’S College Criteria

scholarly journals The Role of Predictive Models in the Assessment of the Poor Outcomes in Pediatric Acute Liver Failure

2022 ◽  
Vol 11 (2) ◽  
pp. 432
Author(s):  
Tudor Lucian Pop ◽  
Cornel Olimpiu Aldea ◽  
Dan Delean ◽  
Bogdan Bulata ◽  
Dora Boghiţoiu ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Prognostic Index ◽  
Prognostic Scores ◽  
Severe Condition ◽  
King's College ◽  
King’S College Criteria ◽  
Poor Outcomes ◽  
Predictive Strength ◽  
Fatal Evolution

Objectives: In children, acute liver failure (ALF) is a severe condition with high mortality. As some patients need liver transplantation (LT), it is essential to predict the fatal evolution and to refer them early for LT if needed. Our study aimed to evaluate the prognostic criteria and scores for assessing the outcome in children with ALF. Methods: Data of 161 children with ALF (54.66% female, mean age 7.66 ± 6.18 years) were analyzed based on final evolution (32.91% with fatal evolution or LT) and etiology. We calculated on the first day of hospitalization the PELD score (109 children), MELD, and MELD-Na score (52 children), and King’s College Criteria (KCC) for all patients. The Nazer prognostic index and Wilson index for predicting mortality were calculated for nine patients with ALF in Wilson’s disease (WD). Results: PELD, MELD, and MELD-Na scores were significantly higher in patients with fatal evolution (21.04 ± 13.28 vs. 13.99 ± 10.07, p = 0.0023; 36.20 ± 19.51 vs. 20.08 ± 8.57, p < 0.0001; and 33.07 ± 8.29 vs. 20.08 ± 8.47, p < 0.0001, respectively). Moreover, age, bilirubin, albumin, INR, and hemoglobin significantly differed in children with fatal evolution. Function to etiology, PELD, MELD, MELD-Na, and KCC accurately predicted fatal evolution in toxic ALF (25.33 vs. 9.90, p = 0.0032; 37.29 vs. 18.79, p < 0.0001; 34.29 vs. 19.24, p = 0.0002, respectively; with positive predicting value 100%, negative predicting value 88.52%, and accuracy 89.23% for King’s College criteria). The Wilson index for predicting mortality had an excellent predictive strength (100% sensibility and specificity), better than the Nazer prognostic index. Conclusions: Prognostic scores may be used to predict the fatal evolution of ALF in children in correlation with other parameters or criteria. Early estimation of the outcome of ALF is essential, mainly in countries where emergency LT is problematic, as the transfer to a specialized center could be delayed, affecting survival chances.

2Efficacy of the King's College criteria to assess prognosis in adults and children with acute liver failure

2000 ◽  
Vol 6 (3) ◽  
pp. C1-C1
Author(s):  
F VILLAMIL ◽  
J TRENTADUE ◽  
N SPERHS ◽  
M RAFFA ◽  
A BOLOGNA ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
King's College ◽  
King’S College Criteria ◽  
Adults And Children
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