Incidence and outcome of ischemic hepatitis complicating septic shock
Article first published online: 15 MAR 2009
© 2009 The Japan Society of Hepatology
Volume 39, Issue 7, pages 700–705, July 2009
How to Cite
Raurich, J. M., Pérez, O., Llompart-Pou, J. A., Ibáñez, J., Ayestarán, I. and Pérez-Bárcena, J. (2009), Incidence and outcome of ischemic hepatitis complicating septic shock. Hepatology Research, 39: 700–705. doi: 10.1111/j.1872-034X.2009.00501.x
- Issue published online: 22 JUN 2009
- Article first published online: 15 MAR 2009
- Received 27 October 2008; revision 5 December 2008; accepted 22 December 2008.
- hepatic dysfunction;
- intensive care unit;
- ischemic hepatitis;
- septic shock;
- SOFA score
Aim: The specific incidence of ischemic hepatitis in septic shock patients remains unknown. The aim of this study was to evaluate the incidence of ischemic hepatitis in septic shock and its relationship with mortality.
Methods: We retrospectively studied 181 patients with septic shock admitted to the intensive care unit (ICU). We defined ischemic hepatitis as having a value of serum aminotransferases equal to or higher than 1000 IU/L. We recorded the age, sex, comorbidity, site of infection, the Sequential Organ Failure Assessment (SOFA) score on admission to the ICU, maximum SOFA score and inadequate antibiotic therapy.
Results: Twenty-five (13.8%) patients developed ischemic hepatitis. In-hospital mortality was 57% (103 patients). In the ischemic hepatitis group, mortality increased up to 84.0% (21 patients) compared with 52.6% (82 patients) in patients without ischemic hepatitis (control group) (odds ratio [OR]: 4.7; 95% confidence interval [CI]: 1.6–14.4; P = 0.003). The development of ischemic hepatitis, age, maximum SOFA score and inadequate antibiotic therapy were independently associated with an increased risk of death. The odds of death increased by 247% in ischemic hepatitis (OR: 3.47; 95% CI: 1.02–11.8; P = 0.047).
Conclusion: Ischemic hepatitis is a common complication in septic shock patients, associated with a high mortality.