Abstract | BACKGROUND/AIMS: METHODS: One hundred and ninety-eight patients were studied retrospectively. The laboratory parameters alanine-aminotransferase, serum bilirubin, serum creatinine and prothrombin index were analyzed over time. Predictors of fatal outcome and survival were determined by receiver-operating-characteristic and sensitivity-specificity analysis. RESULTS: Twenty-three patients died in the median 6.1 days (range, 2.7-13.9 days) after ingestion. Using a single parameter as predictor of fatal outcome the area under the receiver-operating-characteristic curve of prothrombin index (0.96) and serum creatinine (0.93) were both significantly greater (P<0.05) compared with serum bilirubin (0.82) and alanine-aminotransferase (0.69). Prediction of fatal outcome had an optimum, if a prothrombin index less than 25% was combined with a serum creatinine greater than 106 micromol/l from day 3 after ingestion onwards (sensitivity 100%, 95% confidence interval 87-100; specificity 98%, 95% confidence interval 94-100). The median time period between the first occurrence of this predictor in non-survivors and death was 63h (range, 3-230h). CONCLUSIONS:
|
Authors | Martin Ganzert, Norbert Felgenhauer, Thomas Zilker |
Journal | Journal of hepatology
(J Hepatol)
Vol. 42
Issue 2
Pg. 202-9
(Feb 2005)
ISSN: 0168-8278 [Print] Netherlands |
PMID | 15664245
(Publication Type: Journal Article)
|
Chemical References |
- Amanitins
- amatoxin
- Alanine Transaminase
- Bilirubin
|
Topics |
- Adolescent
- Adult
- Alanine Transaminase
(blood)
- Amanitins
(toxicity)
- Bilirubin
(blood)
- Child
- Humans
- Liver Failure
(chemically induced, mortality)
- Liver Transplantation
(statistics & numerical data)
- Mushroom Poisoning
- Predictive Value of Tests
- Prothrombin Time
- Retrospective Studies
- Survival Analysis
|