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Novel classification of acute liver failure through clustering using a self-organizing map: usefulness for prediction of the outcome

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Patients with acute liver failure are classified according to the interval between the onset of hepatitis symptoms and the development of hepatic encephalopathy. We examined the validity of such classifications.

Methods

The subjects were 1,022 patients enrolled in a nationwide survey in Japan. The intervals between the onset of the hepatitis symptoms and the development of encephalopathy were 10 days or less in 472 patients (group-A), between 11 and 56 days in 468 patients (group-B), and longer than 56 days in 82 patients (group-C). Data on a total of 104 items collected from the patients were subjected to clustering using a self-organizing map.

Results

The patients were classified into three clusters. The first cluster consisted of 411 patients (group-A: 57%, group-B: 39%, group-C: 4%). Their incidence of complications was low; 34% underwent liver transplantation (LT), and their survival rate was 90%, while 94% of those treated without transplant were rescued. The second cluster consisted of 320 patients (21, 65, and 14% groups A, B, and C, respectively), who showed a high incidence of complications; the survival rate was 7% in the patients treated conservatively without LT. Sixteen percent underwent LT and survival rate of these patients was 52%. There was a third cluster, of 291 patients (59, 34, and 7% groups A, B, and C, respectively). Without LT, 81% of the patients died. Seven percent were treated by LT and their survival rate was 60%.

Conclusions

Clustering revealed that patients with acute liver failure could be classified into three clusters independent of the interval between the onset of disease symptoms and the development of encephalopathy. This technique may be useful, since the outcomes of the patients differed markedly among the clusters.

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Abbreviations

LOHF:

Late-onset hepatic failure

LT:

Liver transplantation

DIC:

Disseminated intravascular coagulation

SOM:

Self-organizing map

HBV:

Hepatitis B virus

HAV:

Hepatitis A virus

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Acknowledgments

This study was supported by Health Labor Sciences Research Grant, Research on Measures for Intractable Diseases, Ministry of Health, Labor and Welfare of Japan.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Morohongo 38, Moroyama-Machi, Iruma-Gun, Saitama, 350-0495, Japan

    Nobuaki Nakayama, Mie Inao, Sumiko Nagoshi & Satoshi Mochida

  2. Department of Digestive and Life-Style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Makoto Oketani & Hirohito Tsubouchi

  3. Life Sciences Solutions, IBM Japan, Tokyo, Japan

    Yoshihiro Kawamura

  4. Yokohama Rosai Hospital for Labor Welfare Corporation, Yokohama, Japan

    Kenji Fujiwara

Authors
  1. Nobuaki Nakayama
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  2. Makoto Oketani
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  3. Yoshihiro Kawamura
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  4. Mie Inao
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  5. Sumiko Nagoshi
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  6. Kenji Fujiwara
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  7. Hirohito Tsubouchi
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  8. Satoshi Mochida
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Corresponding author

Correspondence to Satoshi Mochida.

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Nakayama, N., Oketani, M., Kawamura, Y. et al. Novel classification of acute liver failure through clustering using a self-organizing map: usefulness for prediction of the outcome. J Gastroenterol 46, 1127–1135 (2011). https://doi.org/10.1007/s00535-011-0420-z

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  • DOI: https://doi.org/10.1007/s00535-011-0420-z

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