Clinical Section: Research Article

Roedl K. · Daniels R. · Theile P. · Fuhrmann V. · Kluge S. · Müller J.

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Article / Publication Details Abstract

Introduction: Hypoxic liver injury (HLI) is a frequent and life-threatening complication occurring in up to 10 % of critically ill patients. Heart failure and age were previously identified as risk factors for occurrence of HLI. However, there is a lack of data on incidence of HLI and its clinical implications on outcome in very old (≥ 90 years) patients. The aim of this study was to investigate occurrence, clinical characteristics and outcome of HLI in critically ill patients ≥ 90 years. Methods: Retrospective analysis of all consecutive critically ill patients ≥ 90 years admitted to the intensive care unit (ICU) of a tertiary care university hospital in Hamburg, Germany. Clinical course and laboratory were analysed from all patients. HLI was defined according to established criteria as elevation of aminotransferase levels (> 20-fold upper limit of normal). Predictors of HLI, occurrence, clinical course and outcome were assessed and compared to patients without HLI. Results: In total, 1065 critically ill patients ≥ 90 years were included. During the ICU stay, 3% (n = 35) developed HLI. Main causes of HLI were cardiogenic shock (51%, n = 18), septic shock (23%, n = 8) and cardiac arrest (20%, n = 7). Presenting characteristics including age, gender and BMI were comparable between patients with and without HLI. The admission cause was primary medical (HLI: 49% vs. No-HLI: 34%, p = 0.07), surgical – planned (9% vs. 38%, p

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