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Statin therapy is associated with reduced incidence of hypoxic hepatitis in critically ill patients
- Source :
- Journal of Hepatology. 60:1187-1193
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Hypoxic hepatitis (HH) is a frequent and life-threatening complication associated with states of oxygen depletion in critically ill patients. Ischemia and reperfusion contribute to liver injury in HH. Experimental data suggest beneficial effects of statins in hepatic ischemia/reperfusion injury. This study was conducted to investigate whether statin treatment prior to intensive care unit (ICU) admission affects incidence rates and severity of HH.Eight hundred fifty-one patients admitted consecutively to three medical ICUs between December 2008 and December 2009 were prospectively screened for new occurrence of HH within 48 h following ICU admission. Statin treatment prior to ICU admission was assessed. 28-day-, 90-day-, and 1-year-survival as well as new-onset of complications in HH patients were prospectively documented.Eighty-seven patients (10%) developed HH. Statin treatment prior to ICU admission was significantly associated with decreased incidence of HH within 48 h after ICU admission in the multivariate analysis (adjusted OR=0.42 (95% CI 0.19-0.95); p0.05). Cardiogenic shock (p0.001), septic shock (p0.001) and active alcohol consumption (p0.01) were identified as independent risk factors for development of HH. 28-day-, 90-day-, and 1-year-mortality rates in HH were 58%, 67%, and 74%, respectively. Statins were associated with improved 28-day-survival in the total study cohort (p0.05), but did not affect 90-day- and 1-year-mortality, respectively.Cardiogenic shock, septic shock, and active alcohol consumption were independent factors predisposing patients to new onset of HH. Statin treatment prior to ICU admission was the only protective factor regarding the new occurrence of HH in critically ill patients.
- Subjects :
- Male
medicine.medical_specialty
Critical Illness
medicine.medical_treatment
Kaplan-Meier Estimate
Severity of Illness Index
Hepatitis
law.invention
Risk Factors
Interquartile range
law
Internal medicine
medicine
Humans
Prospective Studies
Myocardial infarction
Renal replacement therapy
Hypoxia
Intensive care medicine
Aged
Hepatology
business.industry
Septic shock
Incidence
Incidence (epidemiology)
Middle Aged
medicine.disease
Intensive care unit
Angiotensin II
Intensive Care Units
SAPS II
Reperfusion Injury
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Subjects
Details
- ISSN :
- 01688278
- Volume :
- 60
- Database :
- OpenAIRE
- Journal :
- Journal of Hepatology
- Accession number :
- edsair.doi.dedup.....50a7f6ddeab555956576395ed4873b84