2026 Volume 32 Issue 1 Pages 42-48
Objective: Acute liver failure (ALF) is a life-threatening condition associated with high mortality. This study aimed to evaluate the clinical characteristics and prognostic factors of ALF cases treated at our institution.
Methods: We retrospectively reviewed 47 patients diagnosed with ALF between 2014 and 2025. Etiology, complications, treatments, and predictors of poor outcomes (death or liver transplantation) were analyzed using multivariate logistic regression and decision tree analysis.
Results: The mean age was 58 years, and 49% of patients were male. Hepatitis B infection and circulatory disorders were the leading etiologies, each accounting for 25.5% of cases. Major complications included disseminated intravascular coagulation (DIC) in 61.7%, infections in 40.4%, and shock in 36.2% of patients. Intensive care unit (ICU) management was required in 85.1% of cases. Overall, 57.4% of patients survived with medical treatment alone, 38.3% died, and 4.3% underwent liver transplantation. Multivariate analysis identified hepatic encephalopathy (p=0.0098), platelet count (p=0.0152), and Model for End-Stage Liver Disease (MELD) score (p=0.0218) as independent predictors of poor prognosis. Decision tree analysis demonstrated that a MELD score ≥25 was the primary determinant of poor outcomes. Among patients with MELD scores ≥25, a transplant score ≥4 was associated with 100% mortality.
Conclusion: Prognosis in ALF is significantly associated with MELD score, platelet count, and the presence of hepatic encephalopathy. The combined use of scoring systems may enhance risk stratification and support clinical decision-making in the management of ALF.
