Retrospective Analysis Of Clinical Features And Prognosis Of Sepsis-associated Liver Injury

Preface:Sepsis is a common disease in intensive care unit,which is one of the main causes of death in patients with severe disease.The liver is one of the most vulnerable organ damage in patients with sepsis,acute liver injury can occur at any stage of sepsis.Current liver injury induced by sepsis-related incidence,prognosis and risk factors of death there is still controversy,about adult sepsis-associated liver injury incidence and prognosis of fewer large sample studies.In this study,patients with sepsis of retrospective analysis clinical data aimed at sepsis-associated liver injury:clinical characteristics and prognosis.Methods:Retrospective analysis the data of 341 patients with sepsis that were treatmented in the First Affiliated Hospital of China Medical University from January2013 to December 2014.According to the degree of liver injury,341 cases were divided into the injury group and the non injured group,96 cases in the injury group and 245cases in the non injured group.All admitted patients were carefully assessed,screened in strict accordance with the inclusion and exclusion criteria and included in the study if they met the requirements.Patients'age,gender,department origin,presence or absence of emergency surgery,infection sites leading to sepsis,APACHE II and SOFA scores on the first 24 h of ICU admission,duration of mechanical ventilation,serum TBil,AST and ALT during ICU stay,presence or absence of abnormal liver function,as well as time of occurrence and duration of abnormal liver function were collected.Descriptive statistics were performed using SPSS 19.0 software.Measurement data including age,APACHE II score,SOFA score,ICU stay and duration of mechanical ventilation were compared by rank sum test,while count data were compared by X~2test.Logistic regression was employed to analyze the mortality-related factors.P<0.05 was considered statistically different.Results:This study subsume a total of 341 cases of patients with sepsis,including 96patients with liver dysfunction,the incidence was 28.15%,60 cases(62.5%)were male,36 cases(37.5%)were female.The age of the patients was 12 to 89 years old,and the mean age was(56.55±18.13)years,The average time of the 3.22d ICU(1-40d)began to appear in liver injury,66 cases(68.75%)occurred in 1-3d,the average duration of 9.26d(1-45d).There were 17 case with abnormal high bilimbin level,31 cases with increasing glutamic-pyruvic transaminase,48 cases with both increasing bilirubin and glutamic-pyruvic transaminase.with the increase of bile metabolism abnormal bilirubin.Infection sites:68 cases of abdominal infection(70.83%),14 cases of pulmonary infection(14.58%).Different nutritional support in patients with elevated bilirubin and not higher statistically different(P<0.05).Sepsis-associated liver damage of injury deaths in 32 cases,mortality was 33.33%.Incidence of MODS for 70.83%.The mortality rate,mechanical ventilation time and ICU time in the patients with liver function injury were significantly higher than those in the non liver injury group,and there were significant differences(P<0.05).The duration and extent of abnormal liver function of patients with different symptoms had a significant difference(P<0.05).The results of the comparison between the two patients showed that the severe patients were more than those with mild and moderate patients,and the duration of ICU time was prolonged.Varying degrees of abnormal patient their prognosis and duration of symptoms has a statistically significant difference(P<0.05).Conclusions:Liver injury is a common complication of sepsis,male majority,the majority of liver injury occurs in the incidence of sepsis after 72h.The abdominal cavity is the most common sites of infection,followed by the lungs.Most patients with elevated bilirubin.Compared with the non liver injury of sepsis,the mechanical ventilation time and ICU time of the patients with abnormal liver function were significantly prolonged,and the mortality was increased.When the patients developed severe liver injury,the duration of abnormal liver function,mechanical ventilation time and ICU time were significantly longer,the the mortality rate and the occurrence of MODS is more likely to be higher.