Fulminant Hepatic Failure: Clinical Spectrum & Outcome

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Fulminant Hepatic Failure: Clinical Spectrum & Outcome

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5

Abstract

Introduction: Present study was conducted to assess the demographic characteristics, risk factors, causative spectrum, clinical features, natural course and outcome in patients of fulminant hepatic failure. We also tried to study the outcome in relation to risk factors, etiology, clinical and biochemical parameters and derive prognostic indicators that would be relevant to fulminant hepatic failure patients. Materials & Methods: A total of 36 diagnosed cases of Fulminant hepatic failure, fulfilling our inclusion and exclusion criteria were selected for the study. The detailed clinical history, complete general, systemic examination, central nervous system examination and investigation findings was noted in a predesigned proforma. The baseline functional status (motor, sensory, autonomous) was assessed and severity of disease was classified using Modified Parsons-Smith scale of hepatic encephalopathy Classification. Patient’s progress was observed on the basis of parameters in classification and addition laboratory investigations. Patients was followed till the time of discharge or death, if happens. During hospital stay, patients were monitored for occurrence of complications, if any. The outcome of fulminant hepatic failure was measured in terms of duration of recovery and discharge or death. Results: Most of the patients were less than 30 years (52.8%) slight female predominance (55.6% vs 44.4%). Most common cause of fulminant hepatic failure was HEV (36.1%) followed by HBV, Indeterminate Hepatitis, AKT induced, AFLP and Auto-immune Hepatitis. Most of the patients were in encepahalopathy grade III (52.8%), followed by grade II (25%). Out of the total 36 patients, 22 patients died (61.1%), while 14 patients (38.9%) survived. Most common cause of death was cerebral edema (72.7%) while sepsis was the cause in 27.3% patients. Presence of sepsis, high total billirubin and cerebral oedema were significantly associated with poor outcome. Conclusion: Most common cause of fulminant hepatic failure was HEV followed by HBV. The mortality rate with fulminant hepatic failure was high at 61.1% with most common causes being cerebral oedema and sepsis. Presence of cerebral oedema and high total bilirubin levels were significantly associated with poor outcome.

Authors and Affiliations

Pranav Deore, Sayali Bhambar, Smit Janrao, Rahul Rathod

Keywords

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EP ID EP598221
DOI 10.9790/0853-1605126367.
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