The Incidence and Outcomes of Ischemic Hepatitis : A Systematic Review with Meta-analysis
Copyright © 2015 Elsevier Inc. All rights reserved..
BACKGROUND: Ischemic hepatitis is a devastating cause of acute liver injury. Data are limited regarding its incidence and outcomes.
METHODS: Systematic review and meta-analysis of studies from PubMed, EMBASE, and Web of Science with specific search terms. Inclusion criteria included case series with >10 patients and clear case definition (especially liver enzyme levels >10 times the upper limit of normal).
RESULTS: Twenty-four papers met inclusion criteria. A total of 1782 cases were identified in these papers (mean 78 per paper, range 12-322). The pooled average age of the included patients was 64.2 years, and their mean peak aspartate aminotransferase level, alanine aminotransferase level, and total bilirubin were 2423 IU/L, 1893 IU/L, and 2.55 mg/dL, respectively. Ischemic hepatitis was present in 2 of every 1000 admissions; including 2.5 of every 100 intensive care unit admissions and 4 of 10 admissions associated with an aminotransferase level >10 times the upper limit of normal. The pooled proportions of patients with ischemic hepatitis who had a predisposing acute cardiac event or sepsis were 78.2% and 23.4%, respectively. The proportion of patients with a documented hypotensive event of any duration was 52.9%. Overall, the pooled rate of survival to discharge was 51% (range 23.1%-85.7%).
CONCLUSIONS: Ischemic hepatitis is a common cause of severe acute liver injury and is associated with a significant risk of in-hospital death. A major opportunity in the management of ischemic hepatitis is recognition of the condition without documented hypotension.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:128 |
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| Enthalten in: |
The American journal of medicine - 128(2015), 12 vom: 24. Dez., Seite 1314-21 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tapper, Elliot B [VerfasserIn] |
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| Links: |
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| Themen: |
Congestive heart failure |
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| Anmerkungen: |
Date Completed 01.04.2016 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.amjmed.2015.07.033 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM252082427 |
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| 245 | 1 | 4 | |a The Incidence and Outcomes of Ischemic Hepatitis |b A Systematic Review with Meta-analysis |
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| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Ischemic hepatitis is a devastating cause of acute liver injury. Data are limited regarding its incidence and outcomes | ||
| 520 | |a METHODS: Systematic review and meta-analysis of studies from PubMed, EMBASE, and Web of Science with specific search terms. Inclusion criteria included case series with >10 patients and clear case definition (especially liver enzyme levels >10 times the upper limit of normal) | ||
| 520 | |a RESULTS: Twenty-four papers met inclusion criteria. A total of 1782 cases were identified in these papers (mean 78 per paper, range 12-322). The pooled average age of the included patients was 64.2 years, and their mean peak aspartate aminotransferase level, alanine aminotransferase level, and total bilirubin were 2423 IU/L, 1893 IU/L, and 2.55 mg/dL, respectively. Ischemic hepatitis was present in 2 of every 1000 admissions; including 2.5 of every 100 intensive care unit admissions and 4 of 10 admissions associated with an aminotransferase level >10 times the upper limit of normal. The pooled proportions of patients with ischemic hepatitis who had a predisposing acute cardiac event or sepsis were 78.2% and 23.4%, respectively. The proportion of patients with a documented hypotensive event of any duration was 52.9%. Overall, the pooled rate of survival to discharge was 51% (range 23.1%-85.7%) | ||
| 520 | |a CONCLUSIONS: Ischemic hepatitis is a common cause of severe acute liver injury and is associated with a significant risk of in-hospital death. A major opportunity in the management of ischemic hepatitis is recognition of the condition without documented hypotension | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Congestive heart failure | |
| 650 | 4 | |a Congestive hepatopathy | |
| 650 | 4 | |a Hypoxic hepatitis | |
| 650 | 4 | |a Liver failure | |
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| 700 | 1 | |a Sengupta, Neil |e verfasserin |4 aut | |
| 700 | 1 | |a Bonder, Alan |e verfasserin |4 aut | |
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