Predictive Value Of CLIF-OF Score For Prognosis In Patients With Acute Liver Injury Induced By Wild Mushroom Poisoning

Objective: Wild mushroom poisoning with high mortality is rare but serious.The aim of this study is to identify the risk indicators of death in patients with wild mushroom poisoning and a good score tool to predict prognosis.Methods: In this respective study(1/2009-12/2018),the patients(n=105)with wild mushroom poisoning from two hospitals of China Medical University who met the inclusion/exclusion criteria were included.The patients were distributed into the non-survival group and the survival group according to the outcome.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-albumin-bilirubin(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: There were statistically significant differences between the two groups with respect to the grade three or four of hepatic encephalopathy and the peak values of the following markers: neutrophil-lymphocyte ratio(NLR),total bilirubin,conjugated bilirubin,unconjugated bilirubin,activated partial thromboplastin time(APTT),international normalized ratio(INR),D-dimer,plasma ammonia and the nadir values of platelet and fibrinogen.The logistic analysis indicated that high 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: INR and plasma ammonia are independent risk factors of wild mushroom poisoning.CLIF-OF(>9)within 24 h of admission is considered as a satisfactory and practical tool to predict a poor outcome of wild mushroom poisoning.