Hypoxic hepatitis in survivors of out-of-hospital cardiac arrest

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• 作者：Sang Hoon Oh ; MD ; Han Joon Kim ; MD ; PhD ; ^{hanjoon@catholic.ac.kr" class="auth_mail" title="E-mail the corresponding author} ; Kyu Nam Park ; MD ; PhD ; Soo Hyun Kim ; MD ; PhD ; Young Min Kim ; MD ; PhD ; Chun Song Youn ; MD ; Jee Yong Lim ; MD
• 刊名：The American Journal of Emergency Medicine
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：33
• 期：9
• 页码：1166-1170
• 全文大小：424 K

文摘

Hypoxic hepatitis (HH) is commonly observed in out-of-hospital cardiac arrest (OHCA) survivors. The objective of this study was to investigate the incidence, clinical courses, and outcomes of as well as predisposing factors for HH in OHCA survivors.

Methods

The study was based on a registry of cardiac arrest cases from 2009 to 2012 at a tertiary university hospital. We assessed patients' serum aminotransferase levels on return of spontaneous circulation (ROSC) and at 6, 12, 24, 48, and 72 hours postarrest. Hypoxic hepatitis was defined as a rapid increase in serum aminotransferase that reached at least 20 times the upper limit of normal. The patients were classified into 2 groups: the HH group and the non-HH group; we then analyzed the outcomes of the HH group. Independent predisposing factors to HH in this cohort were identified.

Results

Of a total of 535 OHCA cases, 148 patients were enrolled in this study. Hypoxic hepatitis was identified in 13.5% (n = 20) of them. Serum aminotransferase rapidly increased in the first day after return of spontaneous circulation. Of the patients who developed HH, 5 (25%) survived to hospital discharge, and none of these individuals had good neurologic outcomes (Glasgow-Pittsburgh cerebral performance categories 1 and 2). Using multivariate logistic regression, we found that the no flow time was independent predictors of HH (odds ratio, 1.085 [95% confidence interval, 1.027-1.146]; P = .003).

Conclusions

Hypoxic hepatitis occurred frequently in survivors of OHCA. The no flow time was an independent risk factor for HH, which was significantly related to death and poor neurologic outcomes.