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Factors affecting the mortality of pediatric fulminant hepatic failure in relation to hepatitis B virus infection
Author(s) -
CHAN PEICHUN,
CHEN HUEYLING,
KONG MANSHAN,
HUANG FUCHEN,
LEE HUNGCHANG,
LIN CHIEHCHUNG,
LIU CHINGCHUAN,
LEE IHSIEN,
WU TZEECHUNG,
WU SHUFEN,
NI YENHSUAN,
HSU HONGYUAN,
CHANG MEIHWEI
Publication year - 2005
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2005.03923.x
Subject(s) - medicine , gastroenterology , hepatitis b virus , fulminant hepatic failure , liver transplantation , hepatitis b , prothrombin time , mortality rate , bilirubin , fulminant hepatitis , multivariate analysis , hepatitis , immunology , virus , transplantation
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.