Incidence of Ischemic Hepatitis among Patients in Medical Intensive Care Unit and Variations of Clinical and Biochemical Profiles in Patients With and Without Ischemic Hepatitis

Le résumé fourni par la source

Background: Ischemic hepatitis (IH) is a clinical syndrome encountered in critically ill patients that represents a compli-cation of underlying cardiac, circulatory or respiratory failure. Aim of Study: Information is scarce about IH in our coun-try. This study intends to explore incidence of IH, its causes, clinical, biochemical profiles and outcomes. Patients and Methods: This study was conducted over a period of 2 years (from 1st of January 2023 to 31st of Decem-ber 2024) including 1730 patients admitted in the medical in-tensive care unit (ICU) in Al-Gamhouria modern Hospital and Burj Al-Atebba Hospital at Aden governorate in Yemen. IH was diagnosed according to the following diagnostic criteria: Clinical setting, such as heart failure, circulatory or respiratory failure; Rapid rise in plasma aminotransferase level (>20 times the upper limit of normal which is 40 units/L); Exclusion of other causes of raised liver enzymes, especially viral hepatitis, drug-induced hepatopathy or autoimmune hepatitis. Results: IH incidence was 6.5%. Males comprised 61.6% of IH cases, while females 38.4%. Male: female ratio (1.6: 1). Mean age in males: 58.7±12.2 years. Mean age in females: 61.1±12.3 years. The most common underlying cause of IH was shock (54.6%) the most common type within shock associat-ed with IH was cardiogenic shock (80.3%). The most common clinical features of IH were vomiting (54.5%), right upper ab-dominal pain (52.7%) and hepatomegaly (39.3%). While overt jaundice was less common (8.1%). Characteristic laboratory Findings in IH was high aspartate to alanine aminotransferase ratio (AST/ALT ratio: 1.7) and low alanine aminotransferase to lactate dehydrogenase ratio (ALT/ LDH ratio: 0.9). Conclusion: IH should be anticipated among critical care patients with circulatory and/or respiratory compromise. It is best managed by early detection according to clinical criteria and rapid correction of underlying causes in order to prevent end organ damage.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.