Hypoxic hepatitis in cardiac intensive care unit: a study of cardiovascular risk factors, clinical course, and outcomes

Norberto C Chávez-Tapia,¹ Brenda V Balderas-Garces,¹ Patricia Meza-Meneses,¹ Magali Herrera-Gomar,² Sandra García-López,² Octavio Gónzalez-Chon,² Misael Uribe<sup>1

1</sup>Obesity and Digestive Diseases Unit, ²Coronary Care Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico

Introduction: Hypoxic hepatitis (HH) is observed frequently in intensive care units. Information in the cardiac intensive care unit (CICU) is limited. The aim of this study was to analyze the clinical course and outcomes of HH in the specific setting of the CICU.
Methods: We analyzed records of patients with HH admitted to the CICU (Group 1). Data were collected and compared with those of an intermediate group of patients with altered liver test results that did not meet the HH criteria who had a serum aminotransferase level of five to ≤20 times the upper-normal limit (Group 2), and with a control group who had an aminotransferase level less than five times the upper-normal limit (Group 3).
Results: Patients with HH exhibited a worse hemodynamic profile and more of these patients were in shock: 17 (94.4%) in Group 1, 14 (77.8%) in Group 2, and seven (38.9%) in Group 3 (P=0.001). Cardiogenic shock was the most frequent event: 12 (66.7%) in Group 1, 13 (72.2%) in Group 2, and six (33.3%) in Group 3 (P=0.006). The mortality rate was 55.6%. Mechanical ventilation was an independent factor associated with death (odds ratio 12.25, 95% confidence interval 1.26–118.36).
Conclusion: The mortality rate of patients with HH in CICU is high and is associated with ventilatory disturbances.

Keywords: liver dysfunction, mechanical ventilation, hospital mortality

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.