Acetaminophen induced acute liver failure has a generally benign outcome; nearly three-fourths of cases survive without liver transplant. Cases that have a poor prognosis are defined by the King’s College Criteria. All of the following are components of the criteria for acetaminophen induced acute liver failure except:
A. arterial pH
The King’s College Criteria for acute liver failure is used to identify cases with a poor prognosis. It is divided into acetaminophen induced and non-acetaminophen induced cases. The acetaminophen induced criteria includes arterial pH < 7.30 or all of the following: INR > 6.5, serum creatinine > 3.4 mg/dL and grade III/IV hepatic encephalopathy. Bilirubin is not part of the criteria.
Non-acetaminophen induced acute liver failure criteria includes INR > 6.5 or three of the following five criteria: age < 11 or > 40, creatinine > 3 mg/dL, INR > 3.5, idiosyncratic drug reaction, bilirubin > 17.5 mg/dL.