Epidemiological changes in the incidence of acute liver failure at a hospital in Mexico City

Introduction and Objectives

Acute liver failure is a condition that can rapidly progress to multiple organ failure. The main reported cause is paracetamol ingestion in 47%, followed by drug-induced liver injury in 11% and viral hepatitis in 10%. An increase in the incidence in our hospital and a change in the etiology were observed. This study aimed to determine the frequency and etiology of acute liver failure, presentation and outcome of patients in the last 3 years at Juarez Hospital of Mexico.

Materials and Patients

Retrospective, descriptive, observational, cross-sectional study. 20 files with a diagnosis of acute liver failure from May 2020 to May 2023 at Juarez Hospital of Mexico were reviewed. Epidemiological data, clinical manifestations, biochemical parameters, evolution and outcome of the studied population were obtained.

Results

15 patients were incluided, 86.6% were male, 13.3% female, 73.3% of the patients were under 35 years of age. 66.6% were secondary to hepatitis A virus, 13.3% to drug-induced liver injury and 20% autoimmune. In the last 5 months, 53.3% of the cases were presented. 73.3% manifesting as hyperacute, 20% acute and 6.6% subacute. The pattern of presentation of liver injury was hepatocellular in 80% and mixed in 20%. 3 patients received liver transplant (20%), 5 received plasmapheresis (33.3%), and 7 patients received support measures (46.6%). Mortality was 20%.

Conclusions

An increase in cases of acute liver failure was determined in the last 5 months, all secondary to hepatitis A virus, with a hyperacute presentation pattern, all required intensive care management, with 100% survival in patients undergoing liver transplantation or plasmapheresis. Due to these findings, it is necessary to perform multicenter studies to determine a change in the behavior of this virus.

Ethical statement

The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.

Declaration of interests

None

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.