Table 2.
Overall Results and Comparison Between Three Groups.
| Variables | Overall (n = 19) | SS (n = 7) | LT (n = 5) | NS (n = 7) | Significance |
|---|---|---|---|---|---|
| Demographics | |||||
| Age | 32.0 ± 9.6 | 33.4 ± 9.6 | 31.2 ± 13.7 | 31.1 ± 7.3 | 0.896 |
| Sex (M:F) | 7 (36.8%):12 (63.2%) | 1 (14.3%):6 (85.7%) | 3 (60%):2 (40%) | 3 (42.9%):4 (57.1%) | 0.248 |
| Toxicity details | |||||
| Dose ingested (grams) | 21.3 ± 11.2 | 11.4 ± 6.9 | 24.0 ± 6.5 | 29.3 ± 10.2 | 0.003 |
| Ingestion to presentation to our unit | 3(0–10) | 3(2–10) | 5 (3–5) | 2.5 (0–10) | 0.728 |
| Clinical details | |||||
| Comorbidities | Hypertension (1) | Hypertension (1) | 0 | 0 | |
| Jaundice to encephalopathy (JEI) (days) | 4.1 ± 2.3 | 5.1 ± 2.5 | 4.2 ± 0.8 | 2.9 ± 2.4 | 0.178 |
| Ingestion to HE (IHEI) (days) | 4.9 ± 2.5 | 6.2 ± 2.2 | 5.2 ± 1.1 | 3.7 ± 3.2 | 0.247 |
| HE on admission | 12 (63.2%) | 4 (57.1%) | 5 (100.0%) | 3 (42.9%) | 0.119 |
| Peak HE grade > 3 | 12 (63.2%) | 2 (28.6%) | 3 (60%) | 7 (100%) | 0.021 |
| Cardiotoxicity | 4 (21.1%) | 0 (0%) | 1 (20%) | 3 (42.9%) | 0.144 |
| Acute kidney injury (AKI) | 10 (52.6%) | 1 (14.3%) | 3 (60%) | 6 (85.7%) | 0.026 |
| Bone marrow suppression | 6 (31.6%) | 2 (28.6%) | 2 (40%) | 2 (28.6%) | 0.895 |
| Investigations | |||||
| Admission hypoglycemia | 4 (21.1%) | 2 (28.6%) | 2 (40%) | 0 (0%) | 0.203 |
| Peak bilirubin (mg/dL) | 9.7 ± 6.3 | 11.1 ± 6.2 | 11.0 ± 7.8 | 7.4 ± 5.3 | 0.487 |
| Peak AST (U/L) | 897(28–6291) | 725(28–2378) | 3378(187–6291) | 1258(97–4229) | 0.109 |
| Peak ALT (U/L) | 786.8 ± 538.4 | 655.0 ± 417.1 | 1088.0 ± 691.3 | 703.4 ± 522.5 | 0.361 |
| Peak alkaline phosphatase (U/L) | 153.5 ± 71.6 | 161.1 ± 78.8 | 203.0 ± 56.1 | 110.4 ± 52.9 | 0.074 |
| Peak GGTP (U/L) | 110(13–1081) | 110(15–1081) | 288(142–518) | 34(13–118) | 0.156 |
| Lowest Fibrinogen (mg/dl) | 146.9 ± 91.4 | 185.6 ± 104.1 | 88.6 ± 39.0 | 149.9 ± 92.8 | 0.198 |
| Pre-plasmapheresis peak PT-INR | 7.8 (1.2–30.1) | 3.4 (1.2–30.1) | 7.9 (5.6–22.2) | 10.1 (7.2–20.7) | 0.733 |
| Pre-CVVHDF peak lactate (mmol/L) | 11.9 ± 9.2 | 3.8 ± 2 | 15.0 ± 7.2 | 17.7 ± 9.7 | 0.005 |
| Pre-CVVHDF peak Ammonia (μ/dl) | 144(67–997) | 137.5(67–178) | 145(106–208) | 150(98–997) | 0.414 |
| Pre-CVVHDF peak creatinine (mg/dl) | 1.1 (0.6–5.8) | 0.8 (0.6–5.8) | 1.7 (0.7–5.7) | 1.3 (0.8–5.1) | 0.753 |
| Prognostic scores | |||||
| Patients meeting KCC | 15 (78.9%) | 4 (57.1%) | 5 (100%) | 7 (100%) | 0.047 |
| Admission MELD score | 29.9 ± 12.6 | 29.9 ± 12.6 | 36.4 ± 8.0 | 25.3 ± 12.7 | 0.293 |
| Peak MELD score | 35.2 ± 8.0 | 30.7 ± 11.8 | 36.2 ± 3.5 | 38.9 ± 2.3 | 0.156 |
| Admission SOFA score | 9.3 ± 3.9 | 9.1 ± 4.0 | 8.6 ± 3.6 | 9.9 ± 4.5 | 0.867 |
| Peak SOFA score | 15.0 ± 4.0 | 11.4 ± 3.7 | 15.6 ± 2.1 | 18.1 ± 2.4 | 0.002 |
| Delta SOFA score | 5.7 ± 4.2 | 2.3 ± 2.4 | 7.0 ± 2.5 | 8.3 ± 4.5 | 0.012 |
| Management | |||||
| Need for ventilator | 13 (68.4%) | 3 (42.9%) | 3 (60%) | 7 (100%) | 0.063 |
| Need for CVVHDF | 15 (78.9%) | 3 (42.9%) | 5 (100%) | 7 (100%) | 0.013 |
| Need for plasmapheresis | 15 (78.9%) | 4 (57.1%) | 5 (100%) | 6 (85.7%) | 0.171 |
| No of plasmapheresis sessions required | 3 (1–4) | 3(2–4) | 2 (1–3) | 2.5 (1–3) | 0.34 |
| Outcomes | |||||
| Hospital admission (days) | 11.1 ± 7.9 | 12.3 ± 9.2 | 21 ± 2 | 6.1 ± 3.5 | 0.0002 |
| ICU stay (days) | 9.2 ± 5.4 | 8.3 ± 4.9 | 14.8 ± 4.4 | 6.1 ± 3.5 | 0.01 |
ALT, alanine aminotransferase; AST, aspartate aminotransferase; CVVHDF, continuous veno-venous hemodiafiltration; GGTP, gamma-glutamyl transpeptidase; HE, hepatic encephalopathy; KCC, King College criteria; MELD, model for end-stage liver disease; SOFA, sequential organ failure assessment