Ezoddin Neda, Ziamanesh Fateme, Ramandi Alireza, Rohani Pejman, Sohouli MohammadHassan, Alimadadi Hosein
Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center Tehran University of Medical Sciences Tehran Iran.
Liver and Pancreatobiliary Diseases Research Center Digestive Diseases Research Institute, Tehran University of Medical Sciences Tehran Iran.
JGH Open. 2025 Jun 18;9(6):e70164. doi: 10.1002/jgh3.70164. eCollection 2025 Jun.
Early identification of acute hepatitis etiology and specific management is crucial for reducing morbidity and mortality. Therefore, this study aims to investigate the prognostic factors of acute hepatitis in children.
This cross-sectional study was conducted on children with diagnosis of acute hepatitis According to the criteria of ESPHAGAN, admitted to the Children's Hospital from March 2018 to March 2023. Data were analyzed using SPSS statistical software.
A total of 164 patients with acute hepatitis were included, comprising 78 patients with acute liver failure and 86 patients without acute liver failure. Viral infections were identified as the most common etiology of acute hepatitis and were significantly more prevalent in patients without acute liver failure. Wilson's disease was significantly more prevalent in patients with acute liver failure. All patients with viral etiology recovered. Among the 24 patients with Wilson's disease, 14 (58.3%) underwent transplantation, 4 (16.6%) were deceased, and 6 (25%) survived without transplantation. Patients with other etiologies did not experience any mortality, with only 13.8% undergoing transplantation due to autoimmune causes. Low albumin (< 2.5), prolonged PT (> 22), elevated INR (> 3), encephalopathy, low phosphorus (< 3), and a duration of more than 7 days between symptom onset and hospitalization significantly increased the risk of mortality or need for transplantation in patients with acute liver disease.
Albumin levels, PT, INR, encephalopathy, phosphorus levels, and the duration between symptom onset and hospitalization are significant prognostic factors for acute hepatitis in pediatric patients.
早期识别急性肝炎病因并进行针对性治疗对于降低发病率和死亡率至关重要。因此，本研究旨在探讨儿童急性肝炎的预后因素。
本横断面研究对2018年3月至2023年3月期间根据ESPHAGAN标准诊断为急性肝炎并入住儿童医院的儿童进行。数据使用SPSS统计软件进行分析。
共纳入164例急性肝炎患者，其中78例为急性肝衰竭患者，86例无急性肝衰竭。病毒感染被确定为急性肝炎最常见的病因，在无急性肝衰竭的患者中更为普遍。威尔逊病在急性肝衰竭患者中更为普遍。所有病毒病因的患者均康复。在24例威尔逊病患者中，14例（58.3%）接受了移植，4例（16.6%）死亡，6例（25%）未移植存活。其他病因的患者未出现死亡，仅13.8%因自身免疫原因接受移植。低白蛋白（<2.5）、凝血酶原时间延长（>22）、国际标准化比值升高（>3）、肝性脑病、低磷（<3）以及症状出现至住院时间超过7天显著增加了急性肝病患者的死亡或移植风险。
白蛋白水平、凝血酶原时间、国际标准化比值、肝性脑病、磷水平以及症状出现至住院时间是儿童急性肝炎的重要预后因素。
