The Analysis Of Etiology And Prognostic Factors Of 108 Children With Acute Liver Failure

Objective: To analyze the etiology and prognostic factors of pediatric acute liver failure.Methods: The clinical data of children with acute liver failure admitted to Children’s Hospital of Chongqing Medical University from January 2012 to October 2019 were collected.According to the prognosis,children were divided into the effective group and the ineffective group,and the clinical data were analyzed by using EXCEL and SPSS19.0software.Results:(1)There were 108 cases,including 28 cases in the effective group and 80 cases in the ineffective group.(2)Etiology was not clear in52.8% cases(57/108 cases);The first four known causes were toxicosis in32(29.6%),drugs in 7(6.5%),hemophagocytic syndrome in 6(5.6%),and hepatolenticular degeneration in 3(2.8%).73.8%(31/42 cases)of children younger than 3 years old had unclear etiology,while toxicosis was the main etiology of children aged more than 3 years old(42.4%,28/66).(3)Univariate analysis showed that the factors significantly correlated with prognosis were age,hospital stay,blood ammonia,blood lactic acid,prothrombin time,activated partial thromboplastin time,international normalized ratio,hepatic encephalopathy,total bilirubin.In 100 children younger than 12 years old,PELD score was statistically significant for prognosis.Multivariate analysis showed that the main factors significantly correlated with prognosis were total bilirubin and hospital stay(OR=1.01 and 0.827 respectively;P<0.05).Conclusion: The mortality of acute liver failure in children is high,and in most cases the etiology is unknown;Total bilirubin was the risk factor for prognosis.Total bilirubin level above 74.35umol/L was a risk factor for treatment failure,which has a sensitivity of 81.3% and specificity of 53.6%.Sufficient treatment time was a positive factor for good prognosis.