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01-08-2011 | Original

Impact of hypoxic hepatitis on mortality in the intensive care unit

Authors: Valentin Fuhrmann, Nikolaus Kneidinger, Harald Herkner, Gottfried Heinz, Mariam Nikfardjam, Anja Bojic, Peter Schellongowski, Bernhard Angermayr, Maximilian Schöniger-Hekele, Christian Madl, Peter Schenk

Published in: Intensive Care Medicine | Issue 8/2011

Abstract

Purpose

Hypoxic hepatitis (HH) is a form of hepatic injury following arterial hypoxemia, ischemia, and passive congestion of the liver. We investigated the incidence and the prognostic implications of HH in the medical intensive care unit (ICU).

Methods

A total of 1,066 consecutive ICU admissions at three medical ICUs of a university hospital were included in this prospective cohort study. All patients were screened prospectively for the presence of HH according to established criteria. Independent risk factors of mortality in this cohort of critically ill patients were identified by a multivariate Poisson regression model.

Results

A total of 118 admissions (11%) had HH during their ICU stay. These patients had different baseline characteristics, longer median ICU stay (8 vs. 6 days, p < 0.001), and decreased ICU survival (43 vs. 83%, p < 0.001). The crude mortality rate ratio of admissions with HH was 4.62 (95% CI 3.63–5.86, p < 0.001). Regression analysis demonstrated strong mortality risk for admissions with HH requiring vasopressor therapy (adjusted rate ratio 4.91; 95% CI 2.51–9.60, p < 0.001), whereas HH was not significantly associated with mortality in admissions without vasopressor therapy (adjusted rate ratio 1.79, 95% CI 0.52–6.23, p = 0.359).

Conclusions

Hypoxic hepatitis (HH) occurs frequently in the medical ICU. The presence of HH is a strong risk factor for mortality in the ICU in patients requiring vasopressor therapy.

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Title: Impact of hypoxic hepatitis on mortality in the intensive care unit
Authors: Valentin Fuhrmann
Nikolaus Kneidinger
Harald Herkner
Gottfried Heinz
Mariam Nikfardjam
Anja Bojic
Peter Schellongowski
Bernhard Angermayr
Maximilian Schöniger-Hekele
Christian Madl
Peter Schenk
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 8/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-011-2248-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of hypoxic hepatitis on mortality in the intensive care unit

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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