Retrospective analysis of clinical characteristics and prognosis of patients with sepsis related liver injury
- Author:
Ying CAO
1
;
Zheng-gang LUAN
;
Liang WANG
;
Yi-na LIU
;
Bo HU
;
Xiao-chun MA
Author Information
- Publication Type:Journal Article
- Keywords: sepsis; sepsis-related liver injury; prognosis
- From: Chinese Journal of Practical Internal Medicine 2019;39(02):163-167
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE: To analyze the incidence, clinical characteristics and prognosis of sepsis-related liver injury(SELI). METHODS: The data of septic patients in the department of Critical Care Medicine of the First Affiliated Hospital of China Medical University from January 2013 to December 2014 were collected and the basic information, infection site, emergency operation and residence were recorded. Also, the duration of ICU, the first 24 h APACHE II and SOFA score, mechanical ventilation, MODS, nutritional support, serum total bilirubin and aminotransferase, the duration of liver dysfunction and the duration of liver dysfunction during ICU stay were recorded. Rank sum test was used to compare age, APACHE II score, SOFA score, length of stay in ICU, duration of mechanical ventilation; Chi square test was used to compare the patient's source, type of operation, whether MODS, and nutritional support; The logistic regression analysis was used to analyze the related factors of death. RESULTS: A total of 341 septic patients with sepsis were included in the study, including 96 patients with septis-related liver dysfunction. The main manifestations were elevated transaminase in 17 cases(17.71%), elevated bilirubin in 31 cases(32.29%), elevated bilirubin and transaminase in 48 cases(50%) and liver injury in 66 cases(68.75%) of sepsic patients occurred within 1-3 days of ICU 3.22 days(1-40 days). The morbidity and mortality of MODS in sepsis-related liver injury patients were 70.83% and 33.33%. Statistically differences in APACHE II scores, SOFA scores, mechanical ventilation duration, and MODS in patients with different prognosis were revealed. Further logistic regression analysis showed that sepsis with MODS was an independent risk factor for death. There were statistical difference in duration of symptoms, duration of ICU stay and prognosis. CONCLUSION: The morbidity of SELI is high, mostly in the early stage of sepsis, men are more prone to the disease. The abdominal cavity is the most common site of infection. High APACHEII score, prolonged mechanical ventilation and MODS are independent risk factors for SELI.
