Sepsis-associated Cholestasis in Adult Patients: A Prospective Study

被引:11
作者
Fan, He-Bin [1 ]
Yang, Dong-Liang [2 ]
Chen, An-Shen [1 ]
Li, Zhi [1 ]
Xu, Li-Tong [1 ]
Ma, Xiao-Ju [1 ]
Zhou, Hao [1 ]
Tian, Zhan-Fei [1 ]
Wu, Juan-Juan [1 ]
Yan, Fu-Ming [1 ]
机构
[1] Peoples Liberat Army 161 Hosp, Dept Infect Dis, Wuhan 430010, Hubei Province, Peoples R China
[2] Huazhong Univ Sci & Technol, Dept Infect Dis, Tongji Med Coll, Union Hosp, Wuhan 430074, Hubei Province, Peoples R China
关键词
Sepsis; Cholestasis; SOFA; APACHE II; BACTEREMIA; JAUNDICE; HYPERBILIRUBINEMIA; INFLAMMATION; ENDOTOXEMIA; DYSFUNCTION; PREVALENCE; SEPTICEMIA; MORTALITY; DISEASE;
D O I
10.1097/MAJ.0b013e3182955457
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background:Sepsis-associated cholestasis is a common problem in neonatal patients. However, there are limited data related to sepsis-associated cholestasis in adults. In this study, the authors assessed the clinical characteristics, risk factors and outcome of adult patients with sepsis-associated cholestasis.Methods:An observational prospective single-center study was conducted. A total of 608 patients with sepsis (66 patients with cholestasis and 542 without evidence of cholestasis) from January 1, 2005, to December 31, 2011, were included from the infectious disease unit. Demographic, clinical and laboratory information were recorded on admission for all patients. Additional data were also collected on the day of the 1st episode of bacteremia for patients who developed cholestasis. Accordingly, the organ dysfunction scores (Acute Physiology and Chronic Health Evaluation [APACHE] II and Sequential Organ Failure Assessment [SOFA]) were assessed on the same day.Results:The mean age of the 608 patients was 49.3 11.4 years (range, 22-83 years); 312 (51.3%) patients were men, 296 (48.7%) were women. The mean APACHE II and SOFA score were 15.2 +/- 6 and 5.6 +/- 2.3, respectively. Sepsis-associated cholestasis was strongly associated with older age, biomarkers of organ dysfunction and clinical composite scores (APACHE II and SOFA). Mortality was higher in patients with sepsis-associated cholestasis (10.6%) compared with subjects with sepsis without cholestasis (1.5%) (P < 0.05).Conclusions:The authors found that sepsis-associated cholestasis affects the outcome of patients with sepsis in the infectious disease unit. Additional clinical studies are necessary to elucidate the pathology and pathophysiology of sepsis-associated cholestasis.
引用
收藏
页码:462 / 466
页数:5
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