|Title:||Factors Affecting the Mortality of Pediatric Fulminant Hepatic Failure in Relation to Hbv Infection||Authors:||CHAN, PEI-CHUN
LEE, I- HSIEN
|Keywords:||children;fulminant hepatic failure;prognosis;mortality;viral hepatitis||Issue Date:||2005||Journal Volume:||v.20||Journal Issue:||n.8||Start page/Pages:||1223-1227||Source:||JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY||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.
|Appears in Collections:||醫學系|
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