Analysis of the clinical characteristics in patients with liver failure of unknown etiology

Objective 　To investigate the clinical characteristics and prognosis in patients with liver failure of unknown etiology (LFUE). Methods 　Clinical data of 326 LFUE patients in 302 Hospital of PLA from January 2005 to December 2014 were analyzed retrospectively. Results 　LFUE accounted for 6.50% of the total liver failure, and its incidence was lower than that of HBV-related liver failure and alcohol-related liver failure. LFUE was presented mainly as subacute liver failure (39.88%), followed by acute-on-chronic liver failure (36.50%) and acute liver failure (23.62%), while other types of liver failure (known etiology) were presented mainly as acute-on-chronic liver failure (92.16%). Compared with HBV-related acute-on-chronic liver failure, the deterioration of liver function in LFUE patients was worse (ALT, AST and TBIL were higher and PTA was lower), ALP and the average level of white blood cells were also much higher. LFUE occurred mainly in adult patients (≥18 years, <60 years, accounting for 56.13%), followed by adolescent patients (<18 years old, accounting for 28.53%) and elderly patients (≥60 years old, accounting for 15.34%). LFUE showed a poor prognosis. The overall improvement rate was only 26.07%, and improvement rate was 31.18%, 25.14% and 20.00% in adolescent patients, adult patients and elderly patients, respectively. In the three types of liver failure, improvement rate was12.99%, 34.62% and 25.21% for acute liver failure, sub-acute liver failure and acute-on-chronic liver failure patients, respectively. Conclusions 　The incidence of LFUE has been on the increase in recent 10 years, mainly presented as sub-acute liver failure, and it has a predilection for young adult and adolescents with a poor prognosis. DOI: 10.11855/j.issn.0577-7402.2016.01.10