O0062 ACUTE LIVER FAILURE IN CHILDREN: EXPERIENCE WITH 210 PATIENTS
Bibliographic record
Abstract
Introduction: Acute liver failure (ALF) is a devastating condition associated with poor prognosis. Aim: retrospective analysis based on the experience of two pediatric centers concerning the diagnosis, clinical course and outcome of patients with ALF including an attempt to identify prognostic indicators for liver transplantation (LT). Methods: We included children with ages from 1 to 18 years. ALF was defined as acute onset of severe liver failure, evidenced by a decrease in prothrombine time (PT) or INR > 1.5, in a patient without pre-existing liver disease. Clinical and laboratory data were collected from May 1982 to September 2002. Viral infection (HAV, HBV, HCV, EBV and CMV), , metabolic disease, autoimmune and toxic hepatitis were excluded. Patients were followed until discharge (Group 1: G1), death (Group 2: G2) or LT (Group 3: G3). Data from G1 was compared to the other two by one-way analysis of variance for continuous variables and chi square test for categorical variables. All variables statistically significant in univariate analysis to predict mortality/transplantation were included in logistic regression analysis. Results: Complete data are available for 210 patients (107 males/ 103 females). Median age: 5.33 years (1 to 17.4 years), 87% were younger than 10 years old. Final diagnosis: 128 (61%) hepatitis A, 68 (32%) indeterminate and 14 (7%) others. G1 (N=59) were alive, G2 (N=61) were dead and G3 (N=90) had a LT. Hepatic encephalopathy (HE) developed in 174 children (83%). The number of patients with advanced HE (III/IV) was significantly higher for Gs 2 and 3 than for G1 (48.5% versus 7%, p< 0.000). Mean values for peak serum total bilirubin (Bi), PT levels, INR and FV levels were the main significant differences between G1 versus 2 and 3 (Bi: 28.2 mg%, PT: 9.69%, INR: 7.52, FV: 15%, p <0.000) compared to G1 (Bi: 21.15 mg%, PT: 22.16%, INR: 3.15 and FV: 35.91%). Univariate analysis: Bi, FV and PT levels, and HE III/IV were significantly between G1 versus 2 and 3. Multivariate analysis: PT and HE III/IV were the most significant parameters. Conclusion: HAV infection is the predominant diagnosis of ALF in children. LT is applicable only in some cases. The high prevalence of HAV infection could effectively be reduced through improving sanitation and universal HAV immunization. Advanced HE and lower degree of PT were significantly associated with death or need of LT.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".