Clinical characteristics and outcomes of acute liver failure in Vietnam

Understanding the etiologies, clinical characteristics, and outcomes of acute liver failure (ALF) is important for guiding management and evaluating prognosis; however, evidence from Vietnam remains limited. We conducted a prospective single-center cross-sectional observational study involving patients with ALF admitted to Bach Mai Hospital, Vietnam, between January 2020 and July 2021. The study included 60 patients from January 2020 to July 2021 who fulfilled the selection criteria for ALF diagnosis. The mean age of patients was about 53 ± 15 years (range = 21-85 years). Most complications were bleeding (80.0%), metabolic disorders (78.0%), and hypotension (61.6%). The acute subtype was the most common ALF subclassification, accounting for 56.7% of cases. Traditional medicines (21/60 cases) are the most common cause and the leading cause of death, causing 15 out of 45 deaths. Hepatitis B (11/60 cases) and paracetamol (6/60 patients) are the second and third most common causes of ALF, with a mortality rate of 72.7% and 66.7%, respectively. In univariate analyses, older age, higher liver enzyme levels, and more severe clinical complications were significantly associated with mortality (P < .05). In this single-center cohort, traditional medicine was the most frequently identified cause of ALF. Given the small sample size and observational design, these findings should be interpreted cautiously and confirmed in larger multicenter studies. Nevertheless, the findings highlight the importance of improving public awareness regarding the safe use of traditional medicines.