(Press-News.org) London, UK, Thursday 10 April 2014: In the UK paracetamol toxicity is the most common cause of ALF and has a high mortality rate. It is estimated that 150 to 200 deaths and 15 to 20 LTs occur as a result of poisoning each year in England and Wales. LT is the definitive treatment for ALF patients who meet the criteria for transplantation but the current means of selection for LT (the King's College Criteria) are not ideal and do not assess changes in prognostic measures over time or quantify the mortality risk for individual patients.
Experts in London from King's College Hospital and the Foundation for Liver Research studied a large group of patients (500) with paracetamol-related ALF and developed and validated a novel outcome prediction model using sequentially-assessed measures to generate an individualised mortality risk prediction without LT.
320 patients (admitted 2000-2007) formed a training dataset and 180 (2008-2012) were studied for testing over a three-day period after admission to a specialist intensive care unit.
Age, encephalopathy and cardiovascular failure severity on admission, as well as the dynamic variables of arterial pH, lactate and creatinine over the first three days were found to be the best predictors. Prediction of non-transplanted 15-day survival in the training and test groups was 0.95 (95% CI 0.93-0.98) and 0.91 (0.82-1) respectively: significantly higher than the standard Kings College Criteria (0.78 (0.72-0.83), with quantified survival predictions being provided for individual patients.1
Prof. Markus Peck-Radosavljevic, Secretary-General of the European Association for the Study of the Liver and Associate Professor of Medicine, University of Vienna, Austria commented: "Acute liver failure is a devastating condition that triggers a cascade of events that can lead to multiple organ failure and often death."
"This high-performance survival model for paracetamol-induced acute liver failure will enable each individual patient to be assessed quickly and a personalised mortality risk provided. Consequently, this will allow the healthcare professional to make a very informed decision regarding a liver transplant, potentially resulting in improved patient outcomes," he added.
Paracetamol is classified as a mild analgesic and is commonly used for the relief of headaches and other minor aches and pains as well as being a major ingredient in numerous cold and flu remedies. It is widely prescribed and inexpensive to purchase over-the-counter (OTC), making it a common drug taken in overdose. It is particularly toxic when taken in combination with alcohol.
In 1998, the UK government restricted sales of OTC paracetamol to packs of 32 500mg tablets in pharmacies and 16 500mg tablets in non-pharmacy outlets. Pharmacists may provide up to 100 tablets for those with chronic conditions at the pharmacist's discretion
INFORMATION:
Disclaimer: the data referenced in this release is based on the submitted abstract. More recent data may be presented at the International Liver Congress™ 2014.
Notes to Editors
About EASL
EASL is the leading European scientific society involved in promoting research and education in hepatology. EASL attracts the foremost hepatology experts and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.
EASL's main focus on education and research is delivered through numerous events and initiatives, including:
The International Liver CongressTM which is the main scientific and professional event in hepatology worldwide
Meetings including Monothematic and Special conferences, Post Graduate courses and other endorsed meetings that take place throughout the year
Clinical and Basic Schools of Hepatology, a series of events covering different aspects in the field of hepatology
Journal of Hepatology published monthly
Organisation of a Mentorship program and Masterclass to support young investigators starting out on their career path
Participation in a number of policy initiatives at European level
About The International Liver CongressTM 2014
The International Liver Congress™ 2014, the 49th annual meeting of the European Association for the study of the Liver, is being held at ExCel London from April 9 – 13, 2014. The congress annually attracts in excess of 9000 clinicians and scientists from around the world and provides an opportunity to hear the latest research, perspectives and treatments of liver disease from principal experts in the field.
For further information on the studies, or to request an interview, please do not hesitate to contact the EASL Press Office on:
Email: easlpressoffice@cohnwolfe.com
Helena Symeou +44 7976 562 430
Courtney Lock +44 7894 386 422
New prediction model to improve patient survival after paracetamol-related liver failure
2014-04-10
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