Declaration of conflict of interest: None declared.
Prognostic value of biochemical liver parameters in neonatal sepsis-associated cholestasis
Article first published online: 21 DEC 2012
© 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 1, pages E6–E11, January 2013
How to Cite
Oswari, H., Widjaja, R. K., Rohsiswatmo, R. and Cleghorn, G. (2013), Prognostic value of biochemical liver parameters in neonatal sepsis-associated cholestasis. Journal of Paediatrics and Child Health, 49: E6–E11. doi: 10.1111/jpc.12053
This study is supported by the Cipto Mangunkusumo Hospital.
- Issue published online: 16 JAN 2013
- Article first published online: 21 DEC 2012
- Manuscript Accepted: 19 JUL 2012
- sepsis-associated cholestasis
The aim of the study was to evaluate the significance of total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyltransferase (GGT) for predicting outcome in sepsis-associated cholestasis.
A retrospective cohort review of the hospital records was performed in 181 neonates admitted to the Neonatal Care Unit. A comparison was performed between subjects with low and high liver values based on cut-off values from ROC analysis. We defined poor prognosis to be when a subject had prolonged cholestasis of more than 3.5 months, developed severe sepsis, septic shock or had a fatal outcome.
The majority of the subjects were male (56%), preterm (56%) and had early onset sepsis (73%). The poor prognosis group had lower initial values of GGT compared with the good prognosis group (P = 0.003). Serum GGT (cut-off value of 85.5 U/L) and AST (cut-off value of 51 U/L) showed significant correlation with the outcome following multivariate analysis. The odds ratio (OR) of low GGT and high AST were OR 4.3 (95% CI:1.6 to11.8) and OR 2.9 (95% CI:1.1 to 8), respectively, for poor prognosis. In subjects with normal AST values, those with low GGT value had relative risk of 2.52 (95% CI:1.4 to 3.5) for poorer prognosis compared with those with normal or high GGT.
Serum GGT and AST values can be used to predict the prognosis of patients with sepsis-associated cholestasis.