BACKGROUND/AIMS: Low factor V and VII levels are bad prognostic indicators in fulminant hepatic failure (FHF). The prognostic importance of admission versus follow up levels of these factors in patients with acute hepatitis and coagulopathy without encephalopathy has not been evaluated. METHODS: Clinical and laboratory data from 68 consecutive patients with acute hepatitis and coagulopathy but without encephalopathy, during a 6-year period, was retrospectively evaluated. RESULTS: Sixty patients (88%) demonstrated improvement in liver function and coagulation ('survivors'), while 8 patients (12%) died or underwent OLT ('non-survivors'). Survivors had higher admission (P < 0.005) and follow up factor VII levels (P < 0.005) than non-survivors. Follow up factor V levels were higher in survivors (P < 0.02), while admission factor V level was not different between groups (P = NS). Multivariate logistic regression analysis demonstrated that admission factor VII levels predicted outcome (P < 0.006). Area under the ROC curve of factor VII was larger than that of factor V (0.885 and 0.715, respectively, P < 0.02). After 3 days of hospitalization, factor V levels, but not factor VII, independently predicted outcome (P < 0.04). CONCLUSIONS: In patients with hepatitis and coagulopathy without encephalopathy at presentation, admission factor VII level may serve as a reliable prognostic marker. Subsequently, during hospitalization, changes in factor V are better outcome indicators.
BACKGROUND/AIMS: Low factor V and VII levels are bad prognostic indicators in fulminant hepatic failure (FHF). The prognostic importance of admission versus follow up levels of these factors in patients with acute hepatitis and coagulopathy without encephalopathy has not been evaluated. METHODS: Clinical and laboratory data from 68 consecutive patients with acute hepatitis and coagulopathy but without encephalopathy, during a 6-year period, was retrospectively evaluated. RESULTS: Sixty patients (88%) demonstrated improvement in liver function and coagulation ('survivors'), while 8 patients (12%) died or underwent OLT ('non-survivors'). Survivors had higher admission (P < 0.005) and follow up factor VII levels (P < 0.005) than non-survivors. Follow up factor V levels were higher in survivors (P < 0.02), while admission factor V level was not different between groups (P = NS). Multivariate logistic regression analysis demonstrated that admission factor VII levels predicted outcome (P < 0.006). Area under the ROC curve of factor VII was larger than that of factor V (0.885 and 0.715, respectively, P < 0.02). After 3 days of hospitalization, factor V levels, but not factor VII, independently predicted outcome (P < 0.04). CONCLUSIONS: In patients with hepatitis and coagulopathy without encephalopathy at presentation, admission factor VII level may serve as a reliable prognostic marker. Subsequently, during hospitalization, changes in factor V are better outcome indicators.
Authors: Mauricio C Zulian; Marcio F Chedid; Aljamir D Chedid; Tomaz J M Grezzana Filho; Ian Leipnitz; Alexandre de Araujo; Mario R Alvares-da-Silva; Mario G Cardoni; Luciano S Guimaraes; Cleber D P Kruel; Cleber R P Kruel Journal: Langenbecks Arch Surg Date: 2015-02-24 Impact factor: 3.445
Authors: David G Koch; J L Speiser; V Durkalski; R J Fontana; T Davern; B McGuire; R T Stravitz; A M Larson; I Liou; O Fix; M L Schilsky; T McCashland; J E Hay; N Murray; O S Shaikh; D Ganger; A Zaman; S B Han; R T Chung; R S Brown; S Munoz; K R Reddy; L Rossaro; R Satyanarayana; A J Hanje; J Olson; R M Subramanian; C Karvellas; B Hameed; A H Sherker; W M Lee; A Reuben Journal: Am J Gastroenterol Date: 2017-04-25 Impact factor: 10.864
Authors: Anna Rutherford; Lindsay Y King; Linda S Hynan; Chetan Vedvyas; Wenyu Lin; William M Lee; Raymond T Chung Journal: Gastroenterology Date: 2012-08-08 Impact factor: 22.682
Authors: Bertrand Nalpas; Philippe Ichaï; Laure Jamot; Nicolas Carbonell; Marika Rudler; Philippe Mathurin; François Durand; Guido Gerken; Michael Manns; Christian Trautwein; Dominique Larrey; Sylvie Radenne; Christophe Duvoux; Vincent Leroy; Jacques Bernuau; Jamila Faivre; Nicolas Moniaux; Christian Bréchot; Gilles Amouyal; Paul Amouyal; Didier Samuel Journal: PLoS One Date: 2016-03-16 Impact factor: 3.240