Publication:

Comparative study of etiological profile and outcome in acute liver failure

Background Acute liver failure (ALF) is a clinical syndrome that is marked by the sudden loss of hepatic function in a person without chronic liver disease. Clinical and etiological profile varies with geographical area and over time. The objective of this prospective study was to determine the etiological profile and outcome of ALF and to compare it with other major studies from India and US.

Methods A total of 84 consecutive patients with a diagnosis of ALF were included in the study. The variables evaluated were demographic, signs and symptoms, biochemical parameters, etiological profile and outcome.

Results Viral hepatitis 32 (38.1%) was the most common cause of ALF but large number of the patients 30 (35.7%) had indeterminate aetiology. Among viral causes, acute hepatitis E (19.1%) was most common followed by hepatitis B (9.5%) and A (9.5%). Drug or toxic induced liver failure (17.8%) also contributed a significant proportion. Majority of the patients were male (51.9%) and the mean age was 39.48±20.11 years. Aetiology varied with other geographical area and even over time in the same area. Overall mortality was 44 (57.1%) in ALF patients, with highest mortality in indeterminate group (60%).

Conclusions Like the rest of India, viral hepatitis was the common cause of ALF but a large number of patients 30 (35.7%) had indeterminate aetiology. Overall mortality was 57.1%. Our study highlights the differences in the profile of ALF from other earlier studies in India and the west.