A new tool can predict which patients with drug-induced liver injury are “unlikely to survive without a liver transplant.”
The tool, called the DILI-Inpt prognostic score, “outperformed existing systems in identifying which hospitalized patients with severe idiosyncratic drug-induced liver injury were unlikely to recover on their own.”
The acronym DILI “refers to idiosyncratic drug-induced liver injury, an uncommon condition caused by a variety of drugs and herbal and dietary supplements.” Most patients who experience these liver injuries recover after “discontinuation of the culprit drugs, [but] some advance to acute liver failure and may require liver transplantation.” This new tool aims to “better assess such patients so that they can be more quickly sent to a liver transplant center.”
The drugs that induced these liver injuries varied, but included “antimicrobials (42.6%), herbal-dietary supplements (16%), and psychoactive drugs (9.8%). After 21 days, 110 patients (36%) spontaneously survived—i.e., recovered on their own after discontinuing the drug—while 115 required liver transplant and 80 died.” The prognostic score was developed to “predict which patients were most likely to require liver transplant and at highest risk of death.”
The DILI-Inpt prognostic score is composed of “two readily available blood tests (total bilirubin and INR values) and two clinical parameters (encephalopathy grade and use of herbal products).”
