Jain and Dhawan listed prognostic factors for a child with acute liver failure. These were based on criteria from an earlier paper by Dhawan et al. The authors are from King's College London.
Patient selection: pediatric acute liver failure (PALF)
Parameters:
(1) age of the patient in years
(2) peak INR
(3) peak serum total bilirubin in µmol/L
(4) WBC count in 10^9/L
Parameter
Finding
Points
age in years
< 2
1
>= 2
0
peak INR
< 4
>= 4
peak serum total bilirubin
< 235 µmol/L
>= 235 µmol/L
WBC count in 10^9/L
< 9 * 10^9/L
>= 9 * 10^9/L
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the mortality.
• The cumulative mortality is probably without transplantation.
• Hepatic encephalopathy may not develop in children, especially infants.
Total Score
Cumulative Mortality
76%
2
93%
3
96%
4
100%
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Specialty: Gastroenterology