Intensive Care Medicine

, Volume 35, Issue 8, pp 1397–1405 | Cite as

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

  • Valentin Fuhrmann
  • Nikolaus Kneidinger
  • Harald Herkner
  • Gottfried Heinz
  • Mariam Nikfardjam
  • Anja Bojic
  • Peter Schellongowski
  • Bernhard Angermayr
  • Reinhard Kitzberger
  • Joanna Warszawska
  • Ulrike Holzinger
  • Peter Schenk
  • Christian Madl
Original

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.

Keywords

Ischemic hepatitis Shock liver Risk factors Hypoglycemia 

Abbreviations

HH

Hypoxic hepatitis

ICU

Intensive care unit

AST

Serum aspartate transaminase level

ALT

Serum alanine transaminase level

LDH

Lactate dehydrogenase level

INR

International normalized ratio

SAPS

Simplified acute physiology score

SOFA

Sequential organ failure assessment

IQR

Interquartile range

CI

Confidence interval

Supplementary material

134_2009_1508_MOESM1_ESM.doc (112 kb)
Supplementary material (DOC 112 kb)

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Valentin Fuhrmann
    • 1
  • Nikolaus Kneidinger
    • 1
  • Harald Herkner
    • 2
  • Gottfried Heinz
    • 3
  • Mariam Nikfardjam
    • 3
  • Anja Bojic
    • 4
  • Peter Schellongowski
    • 4
  • Bernhard Angermayr
    • 5
  • Reinhard Kitzberger
    • 1
  • Joanna Warszawska
    • 1
  • Ulrike Holzinger
    • 1
  • Peter Schenk
    • 1
  • Christian Madl
    • 1
  1. 1.Intensive Care Unit 13H1, Department of Gastroenterology and Hepatology, Internal Medicine 3Medical University of ViennaViennaAustria
  2. 2.Department of Emergency MedicineMedical University of ViennaViennaAustria
  3. 3.Intensive Care Unit 13H3, Department of Cardiology, Internal Medicine 2Medical University of ViennaViennaAustria
  4. 4.Intensive Care Unit 13I2, Internal Medicine 1Medical University of ViennaViennaAustria
  5. 5.Department of Gastroenterology and Hepatology, Internal Medicine 3Medical University of ViennaViennaAustria

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