Influencing factors for the length of hospital stay in patients with drug-induced liver injury

Du ShuiXian; Lu LinLin; Xin YongNing; Liu Yang; Yuan Chen; Gu JiuLian; Xuan ShiYing

doi:10.3969/j.issn.1001-5256.2016.07.034

Issue 7

Jul. 2016

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Article Navigation > Journal of Clinical Hepatology > 2016 > 32(7): 1368-1372

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Influencing factors for the length of hospital stay in patients with drug-induced liver injury

DOI: 10.3969/j.issn.1001-5256.2016.07.034

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Published Date: 2016-07-20

Abstract

Abstract

Objective To investigate the influencing factors for the length of hospital stay in patients with drug- induced liver injury( DILI),and to guide clinical practice,reduce the pressure of hospitalization,and reduce the patients' economic burden. Methods The clinical data of the patients with DILI who were hospitalized in Qingdao Municipal Hospital from January 2012 to December 2014 were collected,including age,sex,primary disease,medication history,routine blood test,liver function parameters,DILI type,medication,and prognosis.The Spearman rank correlation,Wilcoxon rank sum test,and Kruskal- Wallis H rank sum test were used to analyze the influencing factors for the length of hospital stay. A multivariate linear regression analysis was performed for the factors with statistical significance determined by the univariate analysis. Results The clinical data of 191 patients with DILI were collected. Among these patients,there were 114 male and 77 female patients aged 11- 84 years( mean 50. 83 ± 2. 72 years),and the mean hospital stay was 14 days( range 4- 41 days). Patient's age,the highest levels of alanine aminotransferase( ALT) / alkaline phosphatase( ALP) / total bilirubin( TBil),and the lowest level of prothrombin activity( PTA) were positively correlated with the length of hospital stay( rs= 0. 388,0. 247,0. 172,0. 487,and 0. 120,all P < 0. 05). The presence or absence of the histories of underlying liver disease,hypertension,malignant tumors,tuberculosis,and hyperthyroidism,use of different suspected drugs,therapies for DILI,and DILI types were the influencing factors for the length of hospital stay in patients with DILI( all P < 0. 05). The multivariate linear regression analysis showed that age,the histories of underlying liver disease and malignant tumors,traditional Chinese medicine,antipyretic and analgesic drugs,the highest levels of ALT / ALP / TBil,the lowest level of PTA,therapies for DILI,and DILI types were independent risk factors for the length of hospital stay in patients with DILI( all P < 0. 05).Conclusion Age,the histories of underlying liver disease and malignant tumors,traditional Chinese medicine,antipyretic and analgesic drugs,the highest levels of ALT / ALP / TBil,the lowest level of PTA,therapies for DILI,and DILI types are influencing factors for the length of hospital stay in patients with DILI. Regulation of the influencing factors for the length of hospital stay during clinical diagnosis and treatment can reduce hospital costs and plays an important role in reducing healthcare burden.
- drug-induced liver injury,
- length of stay,
- risk factors

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References

[1]REN DD,DENG CL.The progress of drug induced liver injury[J].J Military Surg Southwest China,2014,16(6):670-672.(in Chinese)任冬冬,邓存良.药物性肝损伤的研究进展[J].西南军医,2014,16(6):670-672.

[2]HUANG CY,LIU YM,HUANG YL,et al.Drug-induced liver injury accompanied by autoimmune phenomena:an analysis of clinical charateristics[J].J Clin Hepatol,2015,31(8):1303-1306.(in Chinese)黄春洋,刘燕敏,黄云丽,等.药物性肝损伤患者伴自身免疫现象的临床特点分析[J].临床肝胆病杂志,2015,31(18):1303-1306.

[3]YANG JW,LIU YX.The progress of traditional Chinese medicine in the treatment of drug-induced liver injury[J].Chin J Tradit Med Sci Technol,2014,21(4):472.(in Chinese)杨洁文,刘云霞.中医药治疗药物性肝损伤的研究进展[J].中国中医药科技,2014,21(4):472.

[4]LI L,JIANG W,WANG JY.Clinical analysis of 275 cases of acute drug-induced liver disease[J].Front Med China,2007,1(1):58-61.

[5]Specialized Committee on Cancer Rehabilitation and Palliative Care,Chinese Anti-cancer Association.A brief introduction to expert consensus on the prevention and treatment of liver injury induced by antitumor drugs(2014)[J].China Med News,2014,29(23):14.(in Chinese)中国抗癌协会癌症康复和姑息治疗专业委员会.肿瘤药物相关性肝损伤防治专家共识(2014)简介[J].中华医学信息导报,2014,29(23):14.

[6]DONATI M,CONFORTI A,LENTI MC,et al.Risk of acute and serious liver injury associated to nimesulide and other NSAIDs:data from drug-induced liver injury case-control study in Italy[J].Br J Clin Pharmacol,2016,82(1):238-248.

[7]LIU XY,CHEN J,WANG XX,et al.Etiological analysis of 3233patients with acute liver failure,subacute liver failure and acuteon-chronic liver failure[J].Clin Med Eng,2012,19(5):823-825.(in Chinese)刘晓燕,陈婧,王晓霞,等.3233例急性、亚急性、慢加急性肝衰竭病因特点分析[J].临床医学工程,2012,19(5):823-825.

[8]KAPLOWITZ N.Idiosyncratic drug hepatotoxicity[J].Nat Rev Drug Discov,2005,4(6):489-499.

[9]Collaborative Group of Hepatobiliary Disease of Digestive Disease Branch of Chinese Medical Association.Recommendation of management for drug induced acute liver injury(Protocal)[J].Chin JDig,2007,27(11):765-767.(in Chinese)中华医学会消化病学分会肝胆疾病协作组.急性药物性肝损伤诊治建议(草案)[J].中华消化杂志,2007,27(11):765-767.

[10]Drug-induced Liver Disease Study Group,Chinese Society of Hepatology,Chinese Medical Association.Guidelines for the management of drug-induced liver injury[J].J Clin Hepatol,2015,31(11):1752-1769.(in Chinese)中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].临床肝胆病杂志,2015,31(11):1752-1769.

[11]Standardization of definitions and criteria of causality assessment of adverse drug reactions.Drug-induced liver disorders:report of an international consensus meeting[J].Int J Clin Pharmacol Ther Toxicol,1990,28(8):317-322.

[12]ZHOU HX,WANG XM,HE WS.The effect and benefit of reducing ALOS on the medical quality in our hospital[J].Chin Health Quality Manage,2006,13(2):11-13.(in Chinese)周汉新,王新民,贺务实.缩短平均住院日对医疗质量与效益的影响[J].中国卫生质量管理,2006,13(2):11-13.

[13]WATKINS PB,SELIGMAN PJ,PEARS JS,et al.Using controlled clinical trials to learn more about acute drug-induced liver injury[J].Hepatology,2008,48(5):1680-1689.

[14]XU XF,WANG F,LIU F,et al.Clinical investigation of drug induced liver injury and its influencing factors analysis[J].Chin J Clin Pharmacol,2014,30(3):216-218.(in Chinese)许雪飞,王菲,刘芬,等.药物性肝损伤临床调查及影响因素分析[J].中国临床药理学杂志,2014,30(3):216-218.

[15]CHALASANI N,FONTANA RJ,BONKOVSKY HL,et al.Causes,clinical features,and outcomes from a prospective study of drug-induced liver injury in the United States[J].Gastroenterology,2008,135(6):1924-1934.

[16]RUSSMANN S,KULLAK-UBLICK GA,GRATTAGLIANO I.Current concepts of mechanisms in drug-induced hepatotoxicity[J].Curr Med Chem,2009,16(23):3041-3053.

[17]WAI CT,TAN BH,CHAN CL,et al.Drug-induced liver injury at an Asian center:a prospective study[J].Liver Int,2007,27(4):465-474.

[18]WANG J,JI L,LIU H,et al.Study of the hepatotoxicity induced by Dioscorea bulbifera L.rhizome in mice[J].Biosci Trends,2010,4(2):79-85.

[19]CHANG BX,ZOU ZS,LI BS.The suggestion of drug-induced liver injury[J/CD].Chin J Liver Dis:Electronic Edition,2015,7(1):123-124.(in Chinese)常彬霞,邹正升,李保森.美国胃肠病协会临床指南:特异质性药物性肝损伤的推荐意见[J/CD].中国肝脏病杂志:电子版,2015,7(1):123-124.

[20]LIU LN,CHEN W,GUO HY,et al.Comparative study on clinical characteristics of 78 cases with drug-induced liver injury caused by Traditional Chinese medicine or Western medicine[J/CD].Chin JLiver Dis:Electronic Edition,2015,7(1):46-50.(in Chinese)刘丽娜,陈婉,郭海燕,等.78例中药与西药引发药物性肝损伤的临床特性研究[J/CD].中国肝脏病杂志:电子版,2015,7(1):46-50.

[21]SUN J,YU F,WANG J.Clinical characteristics and drug analysis in 337 cases of drug-induced liver injury[J].Pharm Clin Res,2013,21(4):383-387.(in Chinese)孙洁,于锋,王坚.337例药物性肝损伤的临床特点及相关药物分析[J].药学与临床研究,2013,21(4):383-387.

[22]LUCENA MI,ANDRADE RJ,KAPLOWITZ N,et al.Phenotypic characterization of idiosyncratic drug-induced liver injury:the influence of age and sex[J].Hepatology,2009,49(6):2001-2009.

[23]HUANG YC,HU CJ,LEE TH,et al.The impact factors on the cost and length of stay among acute ischemic stroke[J].J Stroke Cerebrovasc Dis,2013,22(7):e152-e158.

[24]LU WT,LI J,OU N,et al.An analysis of 276 cases of drug-induced liver damage[J].Chin J Hepatol,2006,14(11):832-834.(in Chinese)陆玮婷,李军,欧宁,等.276例药物性肝损伤的病因和临床表现分析[J].中华肝脏病杂志,2006,14(11):832-834.

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Influencing factors for the length of hospital stay in patients with drug-induced liver injury

DOI: 10.3969/j.issn.1001-5256.2016.07.034