, Volume 35, Issue 8, pp 1397-1405
Date: 09 Jun 2009

Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients

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Abstract

Purpose

Hypoxic hepatitis (HH) is a frequent cause of acute hepatocellular damage at the intensive care unit. Although mortality is reported to be high, risk factors for mortality in this population are unknown.

Methods

One-hundred and seventeen consecutive patients with HH were studied prospectively at three medical intensive care units of a university hospital.

Results

The main causes of hypoxic hepatitis were low cardiac output and septic shock, and most patients (74%) had more than one underlying factor. Peak aspartate transaminase (P = 0.02), lactate dehydrogenase (P = 0.03), INR (P < 0.001) and lactate (P < 0.01) were higher in non-survivors. Prolonged duration of HH caused higher overall mortality rate (P = 0.03). INR > 2 (P = 0.02), septic shock (P = 0.01) and SOFA score >10 (P = 0.04) were risk factors of mortality in the regression model.

Conclusions

Hypoxic hepatitis is the consequence of multiorgan injury. Outcome is influenced by the severity of liver impairment and the etiology and severity of the basic disease.

The study was performed at the intensive care units 13H1, 13H3 and 13I2 of the Medical University of Vienna.