Predicts poor prognosis in paracetamol-induced acute liver failure - indication for transplant referral.
The King's College Criteria — Paracetamol ALF is a GI & Liver scoring tool used in paediatric practice. Predicts poor prognosis in paracetamol-induced acute liver failure - indication for transplant referral. It scores 5 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.
5. They are Arterial pH < 7.30 after adequate fluid resuscitation; Arterial lactate > 3.0 mmol/L after fluid resuscitation; INR > 6.5 (prothrombin time > 100 s); Serum creatinine > 3.4 mg/dL (300 µmol/L); Grade III-IV hepatic encephalopathy.
The total is interpreted as: any score - Criteria not met: transplant criteria not met on current values. Continue N-acetylcysteine and supportive care; repeat assessment - parameters can evolve rapidly; 3 criteria or more - Criteria MET: all three of INR >6.5, creatinine >3.4 mg/dL and grade III-IV encephalopathy - poor prognosis. Refer urgently to a liver transplant centre; 4 criteria or more - Criteria MET: pH <7.30 (or lactate >3.0) after resuscitation - poor prognosis independent of other values. Refer urgently to a liver transplant centre.
No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.
Criteria are met by EITHER: arterial pH <7.30 (or lactate >3.0 after resuscitation) alone, OR all three of INR >6.5, creatinine >3.4 mg/dL and grade III-IV encephalopathy.
Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.