Characteristics and Outcomes of Patients with Acute Liver Failure Admitted to Australian and New Zealand Intensive Care Units.

BACKGROUND: Knowledge about patients with Acute Liver Failure (ALF) in Australia and New Zealand (ANZ) is lacking. We hypothesised that the pattern of disease would be similar to previous studies and that, despite low transplantation rates, mortality would be comparable.

METHODS: We obtained data from the ANZ Intensive Care Society Adult Patient Database and the ANZ Liver Transplant Registry for ten years commencing 2005 and analysed for patient outcomes.

RESULTS: During the study period, 1 022 698 adults were admitted to intensive care units (ICUs) across ANZ, of which 723 had ALF. The estimated annual incidence of ALF over this period was 3.4/million people and increased over time (p=0.001). ALF patients had high illness severity (APACHE III 79.8 vs. 50.1 in non-ALF patients; p<0.0001), and were more likely to be younger, female, pregnant and immunosuppressed. ALF was an independent predictor of mortality (OR 1.5 (1.26-1.79); p<0.0001). At less than 23%, the use of liver transplantation was low, but the mortality of 39% was similar to previous studies.

CONCLUSIONS: ALF is a rare but increasing diagnosis in ANZ ICUs. Low transplantation rates in ANZ for ALF do not appear to be associated with higher mortality rates than reported in the literature. This article is protected by copyright. All rights reserved.