Epidemiology

Obesity a poor prognostic indicator in acute liver failure

Last Updated: 2006-05-25 17:00:19 -0400 (Reuters Health)

By Martha Kerr

LOS ANGELES (Reuters Health) - Obesity doubles the risk of death or need for transplantation in patients with acute liver failure, according to a study presented here this week at Digestive Diseases Week.

Dr. Anna Rutherford of Massachusetts General Hospital and colleagues prospectively identified 572 patients at 24 US medical centers with acute liver failure whose body mass index (BMI) was on record between January 1998 and December 2004.

Of the total, 29.1% were obese. This compares with a prevalence of 30.4% in the adult population, according to the NHANES III database, Dr. Rutherford noted.

Mean BMI in patients with liver failure who died or needed a new liver was 28.8 kg/m2. Mean BMI of spontaneous survivors was 26.6 kg/m2. Need for transplantation or death occurred in 67.1% of obese patients and in 50.7% of non-obese patients, which translated to a 1.9-fold increase in risk of death or transplantation with obesity.

Morbidly obese patients had 2.2 times the risk of death or transplantation. Obese patients had a 3.2-fold increase in risk of death after transplantation as non-obese patients. For patients who were both obese and diabetic (19 patients, or 3.3%) 63.2% died or were transplanted compared with 55% of non-obese, nondiabetic acute liver failure patients.

"Obese patients are known to often have underlying nonalcoholic fatty liver disease," Dr. Rutherford pointed out. "Obesity could aggravate underlying disease...and obese patients generally do more poorly overall."