Abstract
Purpose
Amanita phalloides poisoning with high mortality is rare but serious. The aim of this
study is to identify the risk indicators of death in patients with Amanita phalloides
poisoning and a good score tool to predict prognosis.
Methods
In this respective study (1/2009–12/2018), the patients (n = 105) with Amanita phalloides
poisoning from two hospitals of China Medical University who met the inclusion/exclusion
criteria were included. The laboratory markers and the clinical scoring systems including
Child–Turcotte–Pugh (CTP), Sequential organ failure assessment (SOFA), Liver injury
and Failure evaluation (LiFe), Chronic liver failure-organ failure score system (CLIF-OF),
King's College criteria (KCH criteria), Model for end-stage liver disease (MELD) and
Platelet-bilirubin-albumin (PALBI) within 24 h of admission to the two hospitals were analyzed and area under the curve (AUC) analyses were also performed regarding
the prediction of death.
Results
The data analysis indicated that high international normalized ratio (INR) (>3.6,
AUC = 0.941) and plasma ammonia (>95.1 μmol/L, AUC = 0.805) were closely associated
with mortality after multivariate logistic regression. CLIF-OF (>9) within 24 h with
really good diagnostic accuracy (>90%) significantly outperformed the other scores
in predicting mortality.
Conclusion
CLIF-OF (>9) within 24 h of admission is considered as a satisfactory and practical
tool to predict a poor outcome of Amanita phalloides poisoning.
Abbreviations:
ALF (acute liver failure), ALT (alanine transaminase), APTT (activated partial thromboplastin time), AST (aspartate aminotransferase), AUC (area under the curve), BILD (conjugated bilirubin), BILT (total bilirubin), BUN (blood urea nitrogen), CI (confidence interval), CLIF-OF (Chronic Liver Failure-Organ Failure), CTP (Child-Turcotte-Pugh), HE (hepatic encephalopathy), INR (international normalized ratio), KCH (King's College Hospital criteria), LiFe (Liver injury and Failure evaluation), MELD (Model of End Stage Liver Disease), NLR (neutrophil-lymphocyte ratio), NPV (negative predictive value), PA (predictive accuracy), PALBI (Platelet-albumin-bilirubin), PPV (positive predictive value), ROC curve (receiver operating characteristic curve), SOFA (Sequential Organ Failure Assessment), UNBIL (unconjugated bilirubin), WBC (white blood cell)Keywords
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Article Info
Publication History
Published online: January 16, 2020
Accepted:
January 15,
2020
Received in revised form:
December 22,
2019
Received:
October 13,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
