Prevalence, clinical characteristics and outcomes of hypoxic hepatitis in critically ill patients

S. Jonsdottir, M.B. Arnardottir, J.A. Andresson, H.K. Bjornsson, S.H. Lund, Einar Stefán Björnsson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hypoxic hepatitis (HH) is an important clinical entity in patients in the intensive care unit (ICU). The aims of the study were to assess the etiology, clinical characteristics and outcomes of HH in the ICU of a tertiary hospital. Secondary aim was to analyze the effects of concomitant ischemia in other organs than the liver. Methods: All patients with HH, 2011–2018, in a university hospital ICU were included. Data were collected on etiology, relevant clinical data and outcome. HH was defined by an increase in aminotransferases ≥10 times the upper limit of normal within 48 h from a clinical event of cardiac, circulatory or respiratory failure. Other causes of liver cell necrosis were excluded. Results: Of 9,931 patients hospitalized in the ICU, 159 (1.6%) fulfilled criteria for HH. In-hospital mortality occurred in 85 (53%) and 60 (38%) survived one year. Median ICU stay was five days (interquartile range (IQR) 3–10) and median hospital stay 16 days (IQR 7–32). Shock (48%), cardiac arrest (25%) and hypoxia (13%) were the most common causes of HH. Acute kidney injury (81%), rhabdomyolysis (50%), intestinal ischemia (6%) and ischemic pancreatitis (3%) occurred concomitantly. Age (odds ratio (OR) 1.05 (95% CI 1.02–1.09)), serum lactate (OR 2.61 (95% CI 1.23–5.50)) and lactate dehydrogenase (OR 1.14 (95% CI 1.02–1.27)) were predictors of mortality. Conclusions: Hypoxic hepatitis was related to shock in approximately 50% of cases and associated with high in-hospital mortality. HH was commonly associated with ischemia in other organs. In-hospital mortality was associated with age, lactate and LD.

Original languageEnglish
Pages (from-to)311-318
Number of pages8
JournalScandinavian journal of gastroenterology.
Volume57
Issue number3
Early online date29 Nov 2021
DOIs
Publication statusPublished - Mar 2022

Bibliographical note

Funding Information:
The authors thank Ingibjörg Richter and Helga H. Bjarnadóttir dearly for assisting with data acquisition.

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.

Other keywords

  • aminotransferase levels
  • etiology
  • Hypoxic hepatitis
  • intensive care unit
  • ischemic hepatitis
  • liver disease
  • outcomes
  • shock liver
  • Lifrarbólga
  • Lifrarsjúkdómar
  • Hepatitis/complications
  • Intensive Care Units
  • Prevalence
  • Hospital Mortality
  • Humans
  • Critical Illness
  • Hypoxia/complications

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