title: Causes, clinical features and outcomes of drug-induced liver injury in hospitalized patients in a Chinese tertiary care hospital.
abstract: Drug-induced liver injury (DILI) is an important liver disease in China, owing to the country's huge population and the availability of a multitude of drugs. Consequently, DILI is becoming an increasingly serious health problem. However, there is not enough relevant epidemiological data, and the clinical features of these patients are not clear. We conducted this study to report the causes and clinical features of DILI in hospitalized patients, and identify the mortality and predictive factors. We retrospectively collected and analyzed the data of all hospitalized patients whose discharge diagnosis was DILI at the Second Xiangya Hospital between January 2011 and December 2014. The data analyses were performed using SAS version 9.2. Among the 469 patients who were diagnosed with DILI at discharge, 361 met the criteria for DILI on re-evaluation. The crude annual incidence rate of DILI was 92.95 cases per 100,000 patients. Chinese herbal medicine was identified as the primary cause of DILI in 36.01 % of the patients. The overall mortality was 8.59 %. Alcohol consumption, use of antituberculosis drugs, serum total bilirubin, direct bilirubin, total protein, albumin, thrombinogen time, international normalized ratio, and the model for end-stage liver disease (MELD) score were significantly correlated with DILI-associated mortality. Among them, the MELD score and albumin were found to be independent predictors of outcome in patients with DILI. Chinese herbal medicine was the primary cause of DILI in the identified patients. The MELD score and albumin were independent predictors of outcome in patients with DILI.
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Ou
authors.affiliation: Normin Health Changsha Representative Office, Changsha, 410011 Hunan China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Baozhen
authors.initials: B
authors.lastname: Li
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Xingyu
authors.initials: X
authors.lastname: Liu
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Li
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Shanghai Liver Disease Research Center of Nanjing Military Area, Shanghai, 200235 China.
authors.forename: Chengwei
authors.initials: C
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University, Shanghai, 200127 China.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Mao
authors.affiliation: Liver Diseases Center, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
keywords: Chinese herbal medicine; Drug-induced liver injury; Incidence; Prognosis