Acute liver failure etiology, clinical manifestation and outcomes in adults: Experience of tertiary care hospital in Karachi

Table 1 Demographical and etiological characteristics of patients, n = 102

Variables	n (%)
Age (years), mean ± SD	27.37 ± 6.60
Gender
Male	31(30.4)
Female	71(69.6)
Pregnant	55 (77.5)
Non- Pregnant	16 (32.5)
Gestational age of pregnant (weeks), mean ± SD	34.56 ± 3.80
Marital status
Married	78 (76.5)
Unmarried	24 (23.5)
Ethnicity
Urdu	56 (54.9)
Sindhi	36 (35.3)
Pathan	10 (9.8)
Residence
Rural	45 (44.1)
Urban	57 (55.9)
Socio-economic status
Lower class	59 (57.8)
Middle class	43 (42.2)
Occupation
Housewife	67 (65.7)
Student	18 (17.6)
Shopkeeper	17 (16.7)
Habits
Chewable tobacco	25 (24.5)
None	77 (75.5)

Table 2 Laboratory parameters of study participants

Variable	Mean ± SD
Duration of stay (days)	4.80 ± 3.39
Prothrombin time (seconds)	11.77 ± 1.75
International normalization ratio	1.96 ± 0.59
Alanine aminotransferase (IU/L) [median (IQR)]	[3600 (2060-8655)]
Aspartate aminotransferase (IU/L) [median (IQR)]	[200 (100-267)]
Gamma-glutamyl transferase (IU/L)	104.62 ± 46.90
Alkaline phosphatase (IU/L)	719.51 ± 327.90
Total bilirubin (mg/dL)	15.41 ± 7.13
Direct bilirubin (mg/dL)	7.66 ± 3.12
Albumin (g/L)	3.45 ± 0.50

IQR: Interquartile range.

Table 3 Association of clinical manifestations with mortality and survival, n = 102

Clinical manifestations	Outcome, n (%)		P value
	Died (n = 70)	Survived (n = 32)
Hypertension			0.001a
Yes	-	6 (18.8)
No	70 (100)	26 (81.3)
Eclampsia			0.001a
Yes	-	6 (18.8)
No	70 (100)	26 (81.3)
Sepsis			0.001a
Yes	-	6 (18.8)
No	70 (100)	26 (81.3)
Jaundice			0.000a
Yes	56 (80)	12 (37.5)
No	14 (20)	20 (62.5)
Fever			0.000a
Yes	44 (62.9)	7 (21.9)
No	26 (37.1)	25 (78.1)
Nausea/vomiting			0.491
Yes	50 (71.4)	20 (62.5)
No	20 (28.6)	12 (37.5)
Fatigue			0.009a
Yes	50 (71.4)	14 (43.8)
No	20 (28.6)	18 (56.3)
Abdominal pain			0.015a
Yes	31 (44.3)	6 (18.8)
No	39 (55.7)	26 (81.3)
Rectal bleeding			0.173
Yes	6 (8.6)	-
No	64 (91.4)	32 (100)
Dyspepsia			0.000a
Yes	24 (34.3)	-
No	46 (65.7)	32 (100)

^aP < 0.05.

Table 4 Viral etiology concerning mortality and survival rate

Viral serology	Outcome, n (%)		P value
	Died (n = 70)	Survived (n = 32)
AIH			0.001a
Yes	-	6 (18.8)
No	70 (100)	26 (81.3)
Anti-HAV IgM			0.002a
Reactive	19 (27.1)	-
Non-Reactive	51 (72.9)	32 (100)
HBs Ag			0.173
Reactive	6 (8.6)	-
Non-Reactive	64 (91.4)	32 (100)
HBc IgM			0.95
Reactive	7 (10)	-
Non-reactive	63 (90)	32 (100)
HEV IgM			0.000a
Reactive	51 (72.9)	32 (100)
Non-Reactive	19 (27.1)	-
Anti-HCV Ab			0.105
Reactive	6 (8.6)	7 (21.9)
Non-reactive	64 (91.4)	25 (78.1)

^aP < 0.05.

HAV: Hepatitis A virus; HEV: Hepatitis E virus.

Table 5 Ultrasound findings and grading of hepatic encephalopathy

Variables	Outcome, n (%)		P value
	Died (n = 70)	Survived (n = 32)
Ultrasonography findings			0.582
Liver parenchymal changes	12 (17.1)	7 (21.9)
Hepatomegaly	25 (35.7)	7 (21.9)
Hypoechoic liver	12 (17.1)	6 (18.8)
None	21 (30.0)	12 (37.5)
Encephalopathy grades			0.000a
Grade 0	-	-
Grade I	-	-
Grade II	13 (18.6)	18 (56.3)
Grade III	45 (64.3)	14 (43.8)
Pregnancy			0.000a
Pregnant	23 (32.8)	32 (100)
Non-pregnant	47 (67.2)	-
ICU need			45 (64.3)
Yes	45 (64.3)	14 (43.8)
No	45 (64.3)	18 (56.2)

^aP < 0.05.

ICU: Intensive care unit.