Development of a prognostic model for pediatric acute liver failure in a Brazilian center
Objective: Pediatric acute liver failure (PALF) is a heterogeneous, rare, and severe condition, which outcome is survival due to liver spontaneous recovery or death. The patients who do not recover may be allocated to liver transplantation, which is the standard treatment. This study aimed to build...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Jornal de Pediatria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S002175572200033X |
| _version_ | 1811249575235682304 |
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| author | José Colleti Junior Ana Cristina Aoun Tannuri Uenis Tannuri Artur Figueiredo Delgado Werther Brunow de Carvalho |
| author_facet | José Colleti Junior Ana Cristina Aoun Tannuri Uenis Tannuri Artur Figueiredo Delgado Werther Brunow de Carvalho |
| author_sort | José Colleti Junior |
| collection | DOAJ |
| description | Objective: Pediatric acute liver failure (PALF) is a heterogeneous, rare, and severe condition, which outcome is survival due to liver spontaneous recovery or death. The patients who do not recover may be allocated to liver transplantation, which is the standard treatment. This study aimed to build a prognostic model to support the clinical decision to indicate liver transplantation for patients with PALF in a Brazilian center. Methods: The authors retrospectively analyzed the clinical variables of 120 patients in the liver transplantation program of the 'Children's Institute of the University of São Paulo, Brazil. The authors conducted a univariate analysis of variables associated with survival in PALF. Logistic multivariate analysis was performed to find a prognostic model for the outcome of patients with pediatric acute liver failure. Results: Risk factors were analyzed using univariate analysis. Two prognostic models were built using multiple logistic regression, which resulted in 2 models: model 1(INR/ALT) and model 2 (INR/Total bilirubin). Both models showed a high sensitivity (97.9%/96.9%), good positive predictive value (89.5%/90.4%), and accuracy (88.4%/88.5%), respectively. The receiver operating characteristic was calculated for both models, and the area under the curve was 0.87 for model 1 and 0.88 for model 2. The Hosmer-Lemeshow test showed that model 1 was good. Conclusion: The authors built a prognostic model for PALF using INR and ALT that can contribute to the clinical decision to allocate patients to liver transplantation. |
| first_indexed | 2024-04-12T15:50:04Z |
| format | Article |
| id | doaj.art-cae4c29c14804bd8bbd18daf362a8b88 |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-12T15:50:04Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-cae4c29c14804bd8bbd18daf362a8b882022-12-22T03:26:33ZengElsevierJornal de Pediatria0021-75572022-11-01986607613Development of a prognostic model for pediatric acute liver failure in a Brazilian centerJosé Colleti Junior0Ana Cristina Aoun Tannuri1Uenis Tannuri2Artur Figueiredo Delgado3Werther Brunow de Carvalho4Corresponding author.; Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança, São Paulo, SP, BrazilUniversidade de São Paulo, Departamento de Pediatria, Instituto da Criança, São Paulo, SP, BrazilUniversidade de São Paulo, Departamento de Pediatria, Instituto da Criança, São Paulo, SP, BrazilUniversidade de São Paulo, Departamento de Pediatria, Instituto da Criança, São Paulo, SP, BrazilUniversidade de São Paulo, Departamento de Pediatria, Instituto da Criança, São Paulo, SP, BrazilObjective: Pediatric acute liver failure (PALF) is a heterogeneous, rare, and severe condition, which outcome is survival due to liver spontaneous recovery or death. The patients who do not recover may be allocated to liver transplantation, which is the standard treatment. This study aimed to build a prognostic model to support the clinical decision to indicate liver transplantation for patients with PALF in a Brazilian center. Methods: The authors retrospectively analyzed the clinical variables of 120 patients in the liver transplantation program of the 'Children's Institute of the University of São Paulo, Brazil. The authors conducted a univariate analysis of variables associated with survival in PALF. Logistic multivariate analysis was performed to find a prognostic model for the outcome of patients with pediatric acute liver failure. Results: Risk factors were analyzed using univariate analysis. Two prognostic models were built using multiple logistic regression, which resulted in 2 models: model 1(INR/ALT) and model 2 (INR/Total bilirubin). Both models showed a high sensitivity (97.9%/96.9%), good positive predictive value (89.5%/90.4%), and accuracy (88.4%/88.5%), respectively. The receiver operating characteristic was calculated for both models, and the area under the curve was 0.87 for model 1 and 0.88 for model 2. The Hosmer-Lemeshow test showed that model 1 was good. Conclusion: The authors built a prognostic model for PALF using INR and ALT that can contribute to the clinical decision to allocate patients to liver transplantation.http://www.sciencedirect.com/science/article/pii/S002175572200033XAcute liver failureLiver transplantationRisk factorsPrognosisPediatrics |
| spellingShingle | José Colleti Junior Ana Cristina Aoun Tannuri Uenis Tannuri Artur Figueiredo Delgado Werther Brunow de Carvalho Development of a prognostic model for pediatric acute liver failure in a Brazilian center Jornal de Pediatria Acute liver failure Liver transplantation Risk factors Prognosis Pediatrics |
| title | Development of a prognostic model for pediatric acute liver failure in a Brazilian center |
| title_full | Development of a prognostic model for pediatric acute liver failure in a Brazilian center |
| title_fullStr | Development of a prognostic model for pediatric acute liver failure in a Brazilian center |
| title_full_unstemmed | Development of a prognostic model for pediatric acute liver failure in a Brazilian center |
| title_short | Development of a prognostic model for pediatric acute liver failure in a Brazilian center |
| title_sort | development of a prognostic model for pediatric acute liver failure in a brazilian center |
| topic | Acute liver failure Liver transplantation Risk factors Prognosis Pediatrics |
| url | http://www.sciencedirect.com/science/article/pii/S002175572200033X |
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