kings_college_criteria_acetaminophen: King's College Criteria for Acetaminophen Toxicity

In cliot: Clinical Indices and Outcomes Tools

King's College Criteria for Acetaminophen Toxicity

Description

Calculates the King's College Criteria (KCC) for predicting poor prognosis in patients with Acetaminophen (Paracetamol) induced acute liver failure. Meeting the criteria indicates a high risk of mortality without liver transplantation.

Usage

kings_college_criteria_acetaminophen(arterial_ph, inr, creatinine,
                                     encephalopathy_grade,
                                     creatinine_units = "mg/dL")

Arguments

arterial_ph	Numeric. Arterial blood pH.
inr	Numeric. International Normalized Ratio.
creatinine	Numeric. Serum Creatinine level.
encephalopathy_grade	Numeric (0-4). Grade of hepatic encephalopathy (West Haven Criteria). 0: None. 1: Mild confusion/agitation. 2: Lethargy, disorientation. 3: Somnolence to semi-stupor, responsive to stimuli. 4: Coma.
creatinine_units	String. Units for creatinine input. Options: "mg/dL" (default) or "micromol/L" (or "umol/L").

Details

Criteria for Liver Transplantation are met if: 1. Arterial pH < 7.3 (irrespective of grade of encephalopathy). OR 2. All three of the following occur within a 24-hour period: - INR > 6.5 (PT > 100 seconds) - Serum Creatinine > 3.4 mg/dL (300 µmol/L) - Grade III or IV Encephalopathy

Value

A list containing:

Result	Indication of whether the criteria for poor prognosis are met.
Recommendation	Clinical guidance regarding transplant referral.
Criteria_Fulfilled	Specific conditions that triggered the positive result.

References

O'Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989;97(2):439-445. doi:10.1016/0016-5085(89)90081-4

Examples

# Example 1: Criteria Met (Acidosis)
# pH 7.1, INR 2.0, Cr 1.0, Grade 1 Enceph
kings_college_criteria_acetaminophen(7.1, 2.0, 1.0, 1)

# Example 2: Criteria Met (Triad)
# pH 7.35, INR 7.0, Cr 4.0, Grade 3 Enceph
kings_college_criteria_acetaminophen(7.35, 7.0, 4.0, 3)

# Example 3: Criteria Not Met
# pH 7.35, INR 5.0, Cr 2.0, Grade 2 Enceph
kings_college_criteria_acetaminophen(7.35, 5.0, 2.0, 2)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.