Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Kramer, L; Jordan, B; Druml, W; Bauer, P; Metnitz, PG; Austrian Epidemiologic Study on Intensive Care, ASDI Study Group.
Incidence and prognosis of early hepatic dysfunction in critically ill patients--a prospective multicenter study.
Crit Care Med. 2007; 35(4):1099-1104
Doi: 10.1097/01.CCM.0000259462.97164.A0
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Metnitz Philipp
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- Abstract:
- In critically ill patients, hepatic dysfunction is regarded as a late organ failure associated with poor prognosis. We investigated the incidence and prognostic implications of early hepatic dysfunction (serum bilirubin >2 mg/dL within 48 hrs of admission). Prospective, multicenter cohort study. Thirty-two medical, surgical, and mixed intensive care units. A total of 38,036 adult patients admitted consecutively over a period of 4 yrs. None. Excluding patients with preexisting cirrhosis (n = 691; 1.8%) and acute or acute-on-chronic hepatic failure (n = 108, 0.3%), we identified 4,146 patients (10.9%) with early hepatic dysfunction. These patients had different baseline characteristics, longer median intensive care unit stays (5 vs. 3 days; p < .001) and increased hospital mortality (30.4% vs. 16.4%; p < .001). Hepatic dysfunction was also associated with higher observed-to-expected mortality ratios (1.02 vs. 0.91; p < .001). Multiple logistic regression analysis showed an independent mortality risk of hepatic dysfunction (odds ratio, 1.86; 95% confidence interval, 1.71-2.03; p < .001), which exceeded the impact of all other organ dysfunctions. A case-control study further confirmed these results: Patients with early hepatic dysfunction exhibited significantly increased raw and risk-adjusted mortality compared with control subjects. Our results provide strong evidence that early hepatic dysfunction, occurring in 11% of critically ill patients, presents a specific and independent risk factor for poor prognosis.
- Find related publications in this database (using NLM MeSH Indexing)
- Case-Control Studies -
- Critical Illness - epidemiology
- Critical Illness - mortality
- Female -
- Hospital Mortality -
- Humans -
- Incidence -
- Length of Stay - statistics & numerical data
- Liver Diseases - diagnosis
- Liver Diseases - epidemiology
- Male -
- Middle Aged -
- Outcome Assessment (Health Care) - statistics & numerical data
- Prognosis -
- Prospective Studies -
- Risk Assessment -
- Find related publications in this database (Keywords)
- hepatic failure
- liver
- outcome
- bilirubin
- epidemiology