title: Analysis of elevated liver enzymes in an acute medical setting: jaundice may indicate increased survival in elderly patients with bacterial sepsis.
abstract: BACKGROUND /AIM: It has been shown previously that in primary care settings in UK abnormal liver enzymes are not adequately investigated and followed up; hence potentially treatable chronic liver diseases remain undiagnosed. No such published data is available with regard to secondary care settings. The aims of this audit were, to determine if the current practice in our hospital with regards to investigation, management and follow-up of patients with elevated liver enzymes is in accordance with American Gastroenterology Association (AGA) guidelines and to analyze the effect of age and elevated parameters of liver blood tests on mortality in patients with bacterial sepsis .
  
  
  METHODS
  A total of 4816 patients were admitted to our acute medical receiving unit during a period of 6 months, of which 378 were with elevated liver enzymes.
  
  
  CONCLUSIONS
  The common conditions that resulted in elevated liver enzymes were sepsis (123) and alcohol-related liver diseases (120). All patients with elevated parameters of liver function tests (LFTs) were fully investigated, managed and followed up in accordance with AGA guidelines. In addition, in patients with bacterial sepsis, old age was associated with increased mortality, while development of jaundice in elderly patients with bacterial sepsis was associated with increased survival.
authors.affiliation: Crosshouse Hospital, Kilmarnock KA2 0BE, Scotland, UK. amir.shah@aaaht.scot
authors.forename: Amir A
authors.initials: AA
authors.lastname: Shah
authors.forename: Michael
authors.initials: M
authors.lastname: Patton
authors.forename: Wajahat H
authors.initials: WH
authors.lastname: Chishty
authors.forename: Amir
authors.initials: A
authors.lastname: Hussain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D004796:Clinical Enzyme Tests; D019983:Guideline Adherence; D006801:Humans; D007565:Jaundice / Q000150:complications*; D008099:Liver / Q000201:enzymology; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis*; D008108:Liver Diseases, Alcoholic / Q000150:complications / Q000175:diagnosis; D008111:Liver Function Tests; D008875:Middle Aged; D018805:Sepsis / Q000150:complications / Q000401:mortality*; D055815:Young Adult
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase