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Title: Characteristics and Outcomes of Patients with Acute Liver Failure Admitted to Australian and New Zealand Intensive Care Units.
Austin Authors: Warrillow, Stephen J ;Bailey, Michael;Pilcher, David;Kazemi, Alex;McArthur, Colin;Young, Paul;Bellomo, Rinaldo 
Affiliation: School of Medicine, University of Melbourne, Melbourne, Australia
Medical Research Institute of New Zealand, Auckland, New Zealand
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
Intensive Care Unit, Middlemore Hospital, South Auckland, New Zealand
Department of Intensive Care, Alfred Health, Melbourne, Australia
Department of Intensive Care Royal Melbourne Hospital, Melbourne, Australia
Data Analytics Research and Evaluation (DARE) Centre, Austin Health and The University of Melbourne, Heidelberg, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University School of Public Health and Preventive Medicine, Melbourne, Australia
Medical Research Institute of New Zealand, Auckland, New Zealand
Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
Issue Date: Jul-2019 2018-11-27
Publication information: Internal Medicine Journal 2019; 49(7): 874-885
Abstract: Knowledge about patients with Acute Liver Failure (ALF) in Australia and New Zealand (ANZ) is lacking. We hypothesised that the pattern of disease would be similar to previous studies and that, despite low transplantation rates, mortality would be comparable. We obtained data from the ANZ Intensive Care Society Adult Patient Database and the ANZ Liver Transplant Registry for ten years commencing 2005 and analysed for patient outcomes. During the study period, 1 022 698 adults were admitted to intensive care units (ICUs) across ANZ, of which 723 had ALF. The estimated annual incidence of ALF over this period was 3.4/million people and increased over time (p=0.001). ALF patients had high illness severity (APACHE III 79.8 vs. 50.1 in non-ALF patients; p<0.0001), and were more likely to be younger, female, pregnant and immunosuppressed. ALF was an independent predictor of mortality (OR 1.5 (1.26-1.79); p<0.0001). At less than 23%, the use of liver transplantation was low, but the mortality of 39% was similar to previous studies. ALF is a rare but increasing diagnosis in ANZ ICUs. Low transplantation rates in ANZ for ALF do not appear to be associated with higher mortality rates than reported in the literature. This article is protected by copyright. All rights reserved.
DOI: 10.1111/imj.14167
ORCID: 0000-0002-7240-4106
PubMed URL: 30479057
Type: Journal Article
Subjects: acute liver failure
emergency liver transplantation
paracetamol overdose
Appears in Collections:Journal articles

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