Factors affecting the mortality of pediatric fulminant hepatic failure in relation to hepatitis B virus infection.

Abstract:

AIM:To investigate the factors affecting the outcome of fulminant hepatic failure (FHF) in children in relation to hepatitis B virus (HBV) infection. METHODS:Retrospective review of a total of 94 cases (61 males and 33 females, aged from 1 month to 15 years) recruited from nine tertiary referral centers in Taiwan from 1985 to 1999. RESULTS:The overall mortality rate was 75%. Patients in the mortality group were of an older age, had higher peak total bilirubin levels, a longer prothrombin time, and a lower percentage of HBV positivity (P < 0.001, P = 0.003, P = 0.0027 and P = 0.042, respectively). Mortality was 65% in the HBV positive (n = 42) and 83% in the HBV negative (n = 52) group (P = 0.05). In the HBV positive group, the prothrombin time was noted to be the single factor affecting outcome (P = 0.036). In the HBV negative group, older age and higher peak value of total serum bilirubin were suggestive of poor survival rate (P < 0.001 and P = 0.006, respectively). Multivariate analysis revealed that total bilirubin was the single factor affecting outcome in the HBV-negative group. The mortality rate of HBV positive children in three consecutive time periods without liver transplantation (1985-1989, 1990-1994, 1995-1999) decreased gradually (91, 67 and 38%, respectively, with P = 0.027). This change was not observed in HBV-negative cases. CONCLUSIONS:Hepatitis B virus positive FHF had a lower mortality rate than HBV negative FHF, with each group having different factors affecting mortality.

authors

Chan PC,Chen HL,Kong MS,Huang FC,Lee HC,Lin CC,Liu CC,Lee IH,Wu TC,Wu SF,Ni YH,Hsu HY,Chang MH

doi

10.1111/j.1440-1746.2005.03923.x

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

1223-7

issue

8

eissn

0815-9319

issn

1440-1746

pii

JGH3923

journal_volume

20

pub_type

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