Jaundice increases the rate of complications and one-year mortality in patients with hypoxic hepatitis
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Jaundice increases the rate of complications and one-year mortality in patients with hypoxic hepatitis. / Jäger, Bernhard; Drolz, Andreas; Michl, Barbara; Schellongowski, Peter; Bojic, Andja; Nikfardjam, Miriam; Zauner, Christian; Heinz, Gottfried; Trauner, Michael; Fuhrmann, Valentin.
In: HEPATOLOGY, Vol. 56, No. 6, 12.2012, p. 2297-304.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Jaundice increases the rate of complications and one-year mortality in patients with hypoxic hepatitis
AU - Jäger, Bernhard
AU - Drolz, Andreas
AU - Michl, Barbara
AU - Schellongowski, Peter
AU - Bojic, Andja
AU - Nikfardjam, Miriam
AU - Zauner, Christian
AU - Heinz, Gottfried
AU - Trauner, Michael
AU - Fuhrmann, Valentin
N1 - Copyright © 2012 American Association for the Study of Liver Diseases.
PY - 2012/12
Y1 - 2012/12
N2 - UNLABELLED: Hypoxic hepatitis (HH) is the most frequent cause of acute liver injury in critically ill patients. No clinical data exist about new onset of jaundice in patients with HH. This study aimed to evaluate the incidence and clinical effect of jaundice in critically ill patients with HH. Two hundred and six consecutive patients with HH were screened for the development of jaundice during the course of HH. Individuals with preexisting jaundice or liver cirrhosis at the time of admission (n = 31) were excluded from analysis. Jaundice was diagnosed in patients with plasma total bilirubin levels >3 mg/dL. One-year-survival, infections, and cardiopulmonary, gastrointestinal (GI), renal, and hepatic complications were prospectively documented. New onset of jaundice occurred in 63 of 175 patients with HH (36%). In patients who survived the acute event of HH, median duration of jaundice was 6 days (interquartile range, 3-8). Patients who developed jaundice (group 1) needed vasopressor treatment (P < 0.05), renal replacement therapy (P < 0.05), and mechanical ventilation (P < 0.05) more often and had a higher maximal administered dose of norepinephrine (P < 0.05), compared to patients without jaundice (group 2). One-year survival rate was significantly lower in group 1, compared to group 2 (8% versus 25%, respectively; P < 0.05). Occurrence of jaundice was associated with an increased frequency of complications during follow-up (54% in group 1 versus 35% in group 2; P < 0.05). In particular, infections as well as renal and GI complications occurred more frequently in group 1 during follow-up.CONCLUSION: Jaundice is a common finding during the course of HH. It leads to an increased rate of complications and worse outcome in patients with HH.
AB - UNLABELLED: Hypoxic hepatitis (HH) is the most frequent cause of acute liver injury in critically ill patients. No clinical data exist about new onset of jaundice in patients with HH. This study aimed to evaluate the incidence and clinical effect of jaundice in critically ill patients with HH. Two hundred and six consecutive patients with HH were screened for the development of jaundice during the course of HH. Individuals with preexisting jaundice or liver cirrhosis at the time of admission (n = 31) were excluded from analysis. Jaundice was diagnosed in patients with plasma total bilirubin levels >3 mg/dL. One-year-survival, infections, and cardiopulmonary, gastrointestinal (GI), renal, and hepatic complications were prospectively documented. New onset of jaundice occurred in 63 of 175 patients with HH (36%). In patients who survived the acute event of HH, median duration of jaundice was 6 days (interquartile range, 3-8). Patients who developed jaundice (group 1) needed vasopressor treatment (P < 0.05), renal replacement therapy (P < 0.05), and mechanical ventilation (P < 0.05) more often and had a higher maximal administered dose of norepinephrine (P < 0.05), compared to patients without jaundice (group 2). One-year survival rate was significantly lower in group 1, compared to group 2 (8% versus 25%, respectively; P < 0.05). Occurrence of jaundice was associated with an increased frequency of complications during follow-up (54% in group 1 versus 35% in group 2; P < 0.05). In particular, infections as well as renal and GI complications occurred more frequently in group 1 during follow-up.CONCLUSION: Jaundice is a common finding during the course of HH. It leads to an increased rate of complications and worse outcome in patients with HH.
KW - Aged
KW - Anoxia
KW - Bilirubin
KW - Death, Sudden, Cardiac
KW - Female
KW - Hepatitis
KW - Humans
KW - International Normalized Ratio
KW - Ischemia
KW - Jaundice
KW - Male
KW - Mesentery
KW - Middle Aged
KW - Multivariate Analysis
KW - Norepinephrine
KW - Pneumonia
KW - Prospective Studies
KW - Renal Insufficiency
KW - Renal Replacement Therapy
KW - Respiration, Artificial
KW - Severity of Illness Index
KW - Shock, Cardiogenic
KW - Shock, Septic
KW - Statistics, Nonparametric
KW - Survival Rate
KW - Time Factors
KW - Vasoconstrictor Agents
U2 - 10.1002/hep.25896
DO - 10.1002/hep.25896
M3 - SCORING: Journal article
C2 - 22706920
VL - 56
SP - 2297
EP - 2304
JO - HEPATOLOGY
JF - HEPATOLOGY
SN - 0270-9139
IS - 6
ER -
