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Clin Gastroenterol Hepatol. 2008 Oct;6(10):1140-5. doi: 10.1016/j.cgh.2008.05.013.

Evaluation of a scoring system for assessing prognosis in pediatric acute liver failure.

Author information

  • 1Department of Pediatrics, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA.

Abstract

BACKGROUND & AIMS:

Pediatric acute liver failure (PALF) results in death or need for liver transplantation (LT) in up to 50% of patients. A scoring system for predicting death or LT (Liver Injury Units [LIU] score) in PALF was previously derived by our group, and used peak values during hospital admission of total bilirubin, prothrombin time/international normalized ratio, and ammonia as significant predictors of outcome. The aims of this study were to test the predictive value of the LIU score in a subsequent validation set of patients and to derive a hospital admission LIU (aLIU) score predictive of outcome.

METHODS:

Data were obtained from 53 children admitted with PALF from 2002 to 2006. Outcome was defined at 16 weeks as alive without LT, death, or LT.

RESULTS:

Survival without LT at 16 weeks for each LIU score quartile was 92%, 44%, 60%, and 12%, respectively (P < .001). The receiver operating characteristic C index for predicting death or LT by 4 weeks was 86.3. An admission LIU score was derived using admission total bilirubin and prothrombin time/international normalized ratio. Survival without LT at 16 weeks for each quartile using the aLIU score was 85%, 77%, 69%, and 31% (P = .001). The receiver operating characteristic C index for predicting death or LT by 4 weeks was 83.7.

CONCLUSIONS:

The original LIU score is a valid predictor of outcome in PALF. The aLIU score is promising and needs to be validated in subsequent patients.

PMID:
18928939
[PubMed - indexed for MEDLINE]
PMCID:
PMC2581795
Free PMC Article

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