Development of a prognostic model for pediatric acute liver failure in a Brazilian center

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art_COLLETI JUNIOR_Development_of_a_prognostic_model_for_pediatric_acute_2022.PDF (522.7 KB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2022
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SOC BRASIL PEDIATRIA
Autores
Citação
JORNAL DE PEDIATRIA, v.98, n.6, p.607-613, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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 transplanta-tion 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 Sa similar to o 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 predic-tive 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. (c) 2022 Sociedade Brasileira de Pediatria.
Palavras-chave
Acute liver failure, Liver transplantation, Risk factors, Prognosis, Pediatrics
URI
https://observatorio.fm.usp.br/handle/OPI/51565
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/30
Artigos e Materiais de Revistas Científicas - LIM/36