The Incidence and Outcomes of Ischemic Hepatitis: A Systematic Review with Meta-analysis
Ischemic hepatitis is a devastating cause of acute liver injury. Data are limited regarding its incidence and outcomes. 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). 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%). 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: |
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, Seite 1314 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tapper, Elliot B [VerfasserIn] |
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| Links: |
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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): |
OLC1964879124 |
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| 520 | |a Ischemic hepatitis is a devastating cause of acute liver injury. Data are limited regarding its incidence and outcomes. 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). 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%). 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. | ||
| 540 | |a Nutzungsrecht: Copyright © 2015 Elsevier Inc. All rights reserved. | ||
| 540 | |a © COPYRIGHT 2015 Elsevier B.V. | ||
| 650 | 4 | |a Ischemia - diagnosis | |
| 650 | 4 | |a Hepatitis - etiology | |
| 650 | 4 | |a Hepatitis - complications | |
| 650 | 4 | |a Liver - blood supply | |
| 650 | 4 | |a Hepatitis - diagnosis | |
| 650 | 4 | |a Ischemia - complications | |
| 650 | 4 | |a Hepatitis | |
| 650 | 4 | |a Analysis | |
| 650 | 4 | |a Medical treatment | |
| 650 | 4 | |a Meta-analysis | |
| 650 | 4 | |a Cardiovascular disease | |
| 700 | 1 | |a Sengupta, Neil |4 oth | |
| 700 | 1 | |a Bonder, Alan |4 oth | |
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| 856 | 4 | 2 | |u http://www.ncbi.nlm.nih.gov/pubmed/26299319 |
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