Use of Pediatric Health Information System database to study the trends in the incidence, management, etiology, and outcomes due to pediatric acute liver failure in the United States from 2008 to 2013

Data were collected of children admitted with ALF to 16 US pediatric liver transplant centers from 2008 to 2013 using the PHIS for a retrospective analysis of PALF trends. Patient data linked to the principal diagnosis code for acute necrosis of the liver (570.00) were analyzed for the following: de...

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Bibliographic Details
Published in:Pediatric transplantation 2015-12, Vol.19 (8), p.888-895
Main Authors: Kulkarni, Sakil, Perez, Carla, Pichardo, Caren, Castillo, Lina, Gagnon, Michael, Beck-Sague, Consuelo, Gereige, Rani, Hernandez, Erick
Format: Article
Language:English
Subjects:
acetaminophen
acute liver failure
Adolescent
Child
Child, Preschool
Databases, Factual
Female
hepatic encephalopathy
Humans
Incidence
Infant
Liver Failure, Acute - epidemiology
Liver Failure, Acute - etiology
Liver Failure, Acute - therapy
liver transplant
Liver Transplantation
Logistic Models
Male
Pediatric Health Information System
Renal Dialysis
Retrospective Studies
Risk Factors
Treatment Outcome
trends
United States - epidemiology
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Summary:Data were collected of children admitted with ALF to 16 US pediatric liver transplant centers from 2008 to 2013 using the PHIS for a retrospective analysis of PALF trends. Patient data linked to the principal diagnosis code for acute necrosis of the liver (570.00) were analyzed for the following: demographics, regional differences, changes over time, pharmaceutical trends, procedural trends, associated diagnoses, and patient outcomes. In 52.5% of 583 patients who met the selection criteria for PALF, the etiology remained undetermined. Acetaminophen toxicity (18.7%) was the most common identifiable etiology, and hepatic encephalopathy (38.6%) was the most common complication. Mortality was lower than previously reported; 95.4% survived and 73.2% survived without a liver transplant. Acute respiratory failure (OR = 3.4, p = 0.035), acute kidney injury (OR = 3.6, p = 0.003), and cerebral edema (OR = 3.6, p = 0.02) were independently associated with increased risk of mortality. The use of N‐acetylcysteine in non‐acetaminophen‐related ALF, the use of intracranial pressure monitoring, and the proportion of sepsis decreased significantly during the study period. The PHIS database can be a useful tool to study the future trends of PALF patients.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.12596