Sandbox: HS
Classification
Acute liver failure may be classified on the basis of the duration of the symptoms between the onset of jaundice to the onset of encephalopathy. The different classification systems based on the number of weeks from the appearance of jaundice to the encephalopathy are:
| Classification system | Duration |
|---|---|
| O’Grady System |
|
| Bernuau System |
|
| Japanese System |
|
The 1993 classification defines three subcategories based on the severity and duration of the acute liver failure. [1] The importance of this method of classification is that the pace of the disease evolution strongly influences prognosis. The underlying etiology causing the development of acute liver failure is the other significant determinant in regards to prognosis.[2] This classification system is based upon the duration between onset of jaundice to onset of encephalopathy.
| Classification | Time |
|---|---|
| Hyperacute | 1 week |
| Acute | 1 week - 1 month |
| Subacute | 1 week - 3 months |
Acute liver failure can also be classified into fulminant or subfulminant. Both of these forms have a poor prognosis. It is based upon the duration between onset of hepatic illness, to the development of encephalopathy.[3]
| Classification | Time |
|---|---|
| Fulminant | within 2 months |
| Subfulminant | within 2 months to 6 months |
O’Grady System
The classification of encephalopathy according to the O’Grady system is as follows.[4]
Hyperacute
Hyperacute encephalopathy is an encephalopathy that occurs within 7 days of onset of jaundice.
Acute
Acute encephalopathy is an encephalopathy that occurs within an interval of 8 to 28 days from onset of jaundice.
Subacute
Subacute encephalopathy is an encephalopathy that occurs within 5 to 12 weeks of onset of jaundice.
Bernuau System
The classification of encephalopathy according to the Bernuau system is as follows.[5]
Fulminant
Fulminant encephalopathy is an encephalopathy that occurs within 2 weeks of onset of jaundice.
Subfulminant
Subfulminant encephalopathy is an encephalopathy that occurs within an interval of 2 to 12 weeks from onset of jaundice.
Japanese System
The classification of encephalopathy according to the Bernuau system is as follows.[6]
Fulminant
Fulminant encephalopathy is an encephalopathy that occurs within 8 weeks of onset of jaundice.
Late-Onset
Late onset encephalopathy is an encephalopathy that occurs within an interval of 8 to 24 weeks from onset of jaundice.
Acute
Acute encephalopathy is an encephalopathy that occurs within 10 days of onset of jaundice
Subacute
Subacute encephalopathy is an encephalopathy that occurs within an interval of 11 to 56 days from onset of jaundice
- ↑ O'Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet 1993;342:273-5. PMID 8101303.
- ↑ O'Grady JG (2005). "Acute liver failure". Postgraduate medical journal. 81 (953): 148–54. doi:10.1136/pgmj.2004.026005. PMID 15749789.
- ↑ Williams R (1996). "Classification, etiology, and considerations of outcome in acute liver failure". Seminars in Liver Disease. 16 (4): 343–8. doi:10.1055/s-2007-1007247. PMID 9027947. Retrieved 2012-10-26. Unknown parameter
|month=ignored (help) - ↑ O'Grady, JG.; Schalm, SW.; Williams, R. (1993). "Acute liver failure: redefining the syndromes". Lancet. 342 (8866): 273–5. PMID 8101303. Unknown parameter
|month=ignored (help) - ↑ Bernuau, J.; Rueff, B.; Benhamou, JP. (1986). "Fulminant and subfulminant liver failure: definitions and causes". Semin Liver Dis. 6 (2): 97–106. doi:10.1055/s-2008-1040593. PMID 3529410. Unknown parameter
|month=ignored (help) - ↑ Mochida, S.; Nakayama, N.; Matsui, A.; Nagoshi, S.; Fujiwara, K. (2008). "Re-evaluation of the Guideline published by the Acute Liver Failure Study Group of Japan in 1996 to determine the indications of liver transplantation in patients with fulminant hepatitis". Hepatol Res. 38 (10): 970–9. doi:10.1111/j.1872-034X.2008.00368.x. PMID 18462374. Unknown parameter
|month=ignored (help)