The incidence, presentation, outcomes, risk of mortality and economic data of drug-induced liver injury from a national database in Thailand: a population-base studyReport as inadecuate




The incidence, presentation, outcomes, risk of mortality and economic data of drug-induced liver injury from a national database in Thailand: a population-base study - Download this document for free, or read online. Document in PDF available to download.

BMC Gastroenterology

, 16:135

Hepatobiliary and pancreatic disorders

Abstract

BackgroundToxic liver diseases are mainly caused by drug-induced liver injury DILI. We assessed incidences and outcomes of DILI including associated factors for mortality.

MethodsWe performed a population-based study of hospitalized patients with DILI. Information was retrieved from the Nationwide Hospital Admission Data using ICD-10 code of toxic liver diseases K71 and additional codes T36–T65. The associated factors were analyzed with log-rank test, univariate and multiple cox regression analysis.

ResultsDuring 2009–2013, a total of 159,061 average 21,165 per year admissions were related to liver diseases. 6,516 admissions 1,303 per year were due to toxic liver diseases. The most common type of toxic liver disease was acute hepatitis 33.5 %. In-hospital and 90-day mortality rates were 3.4 % and 17.2 %. DILI with cirrhosis yielded the highest in-hospital and 90-day mortality rates 15.8 % and 47.4 %. Acetaminophen, cirrhosis and age ≥ 60 years were seen in 0.5 %, 8.3 % and 50.1 % of patients who died versus 5 %, 2.3 % and 32.4 % of survivors. Factors associated with mortality were cirrhosis HR 2.72, 95 % CI: 2.33–3.19, age ≥60 years HR 2.16, 95 % CI: 1.96–2.38, human immunodeficiency viral infection HR 2.11, 95 % CI: 1.88–2.36, chronic kidney disease HR 1.59, 95 % CI: 1.33–1.90, chronic obstructive pulmonary disease and bronchiectasis HR 1.55, 95 % CI: 1.17–2.04, malnutrition HR 1.43, 95 % CI: 1.10–1.86 and male HR 1.31, 95 % CI: 1.21–1.43. Acetaminophen DILI yielded lower risks of mortality HR 0.24, 95 % CI: 0.13–0.42. The most common causes of DILI were acetaminophen 35.0 % and anti-tuberculous drugs 34.7 %.

ConclusionsDILI is an uncommon indication for hospitalization carrying lower risks of death except in patients with non-acetaminophen, cirrhosis, elderly or concomitant diseases.

KeywordsDrug-induced liver injury Hepatitis Cirrhosis Acetaminophen Anti-mycobacterial agents AbbreviationsALFAcute liver failure

CIConfidence interval

CKDChronic kidney disease

COPDChronic obstructive pulmonary diseases

DILIDrug-induced liver injury

HIVHuman immunedeficiency virus

HRHazard ratio

ICDInternational classification of disease

NHSONational health security office

Download fulltext PDF



Author: Abhasnee Sobhonslidsuk - Kittiyod Poovorawan - Ngamphol Soonthornworasiri - Wirichada Pan-ngum - Kamthorn Phaosawasdi

Source: https://link.springer.com/







Related documents