title: Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients.
abstract: OBJECTIVE
  Hypoxic hepatitis (HH) is a frequent cause of acute hepatocellular damage at the intensive care unit. Although mortality is reported to be high, risk factors for mortality in this population are unknown.
  
  
  METHODS
  One-hundred and seventeen consecutive patients with HH were studied prospectively at three medical intensive care units of a university hospital.
  
  
  RESULTS
  The main causes of hypoxic hepatitis were low cardiac output and septic shock, and most patients (74%) had more than one underlying factor. Peak aspartate transaminase (P = 0.02), lactate dehydrogenase (P = 0.03), INR (P < 0.001) and lactate (P < 0.01) were higher in non-survivors. Prolonged duration of HH caused higher overall mortality rate (P = 0.03). INR > 2 (P = 0.02), septic shock (P = 0.01) and SOFA score >10 (P = 0.04) were risk factors of mortality in the regression model.
  
  
  CONCLUSIONS
  Hypoxic hepatitis is the consequence of multiorgan injury. Outcome is influenced by the severity of liver impairment and the etiology and severity of the basic disease.
authors.affiliation: Intensive Care Unit 13H1, Department of Gastroenterology and Hepatology, Internal Medicine 3, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. valentin.fuhrmann@meduniwien.ac.at
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuhrmann
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kneidinger
authors.forename: Harald
authors.initials: H
authors.lastname: Herkner
authors.forename: Gottfried
authors.initials: G
authors.lastname: Heinz
authors.forename: Mariam
authors.initials: M
authors.lastname: Nikfardjam
authors.forename: Anja
authors.initials: A
authors.lastname: Bojic
authors.forename: Peter
authors.initials: P
authors.lastname: Schellongowski
authors.forename: Bernhard
authors.initials: B
authors.lastname: Angermayr
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kitzberger
authors.forename: Joanna
authors.initials: J
authors.lastname: Warszawska
authors.forename: Ulrike
authors.initials: U
authors.lastname: Holzinger
authors.forename: Peter
authors.initials: P
authors.lastname: Schenk
authors.forename: Christian
authors.initials: C
authors.lastname: Madl
mesh_terms: D000368:Aged; D001317:Austria / Q000453:epidemiology; D016638:Critical Illness / Q000401:mortality; D005260:Female; D006505:Hepatitis / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D006785:Hospitals, University; D006801:Humans; D007003:Hypoglycemia; D000860:Hypoxia / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012772:Shock, Septic