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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 7
Jul.  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(7): 1626-1631

Clinical features of elderly patients with drug-induced liver failure: An analysis of 65 cases

DOI: 10.3969/j.issn.1001-5256.2021.07.029
  • 1.

    Department of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China

  • 2.

    Department of Hepatology and Spleen-Stomach, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China

  • Received Date: 2020-10-06
  • Accepted Date: 2021-01-15
  • Published Date: 2021-07-20
    Abstract
  •   Objective  To investigate the features and medication of elderly patients with drug-induced liver failure (DILF), and to provide a reference for clinical prevention and treatment of DILF in elderly patients.  Methods  A total of 65 elderly patients, aged ≥60 years, who were diagnosed with DILF in The Fifth Medical Center of Chinese PLA General Hospital from January 2015 to December 2019 were enrolled and divided into groups based on the criteria for clinical outcome evaluation. The patients who were cured or improved were enrolled as response group, and those who had no response or died were enrolled as non-response group. Related clinical data were collected and analyzed, including age, sex, underlying diseases, type of the drug used, clinical classification, complications, and prognosis. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups.  Results  Among the 65 elderly patients with DILF, there were 17 male patients (26.2%) and 48 female patients (73.8%), with a male/female ratio of 1∶ 2.82. Subacute liver failure (SALF) was the main type of DILF in the elderly patients (81.5%), and cholestasis type was the most common clinical type (40%). There were 26 patients in the response group and 39 in the non-response group, accounting for 40% and 60%, respectively, of all patients. As for complications, compared with the non-response group, the response group had a significantly higher proportion of patients with pleuroperitoneal fluid (61.5% vs 28.2%, P < 0.05), a significantly lower proportion of patients with hepatorenal syndrome (19.2% vs 56.4%, P < 0.05), a significantly higher proportion of patients without hepatic encephalopathy (80.8% vs 30.8%, P < 0.05), and a significantly lower proportion of patients with stage 4 hepatic encephalopathy (0 vs 20.5%, P < 0.05). The main drugs causing DILF included cardiovascular and cerebrovascular drugs (10.8%), antihypertensive drugs (9.2%), and antibiotics (7.7%); traditional Chinese medicine drugs were mainly Chinese patent drugs (35.4%) and Chinese herbal medicine (23.1%); healthcare product was the most common type of biological products (20.0%).  Conclusion  SALF is the most common type of DILF in the elderly, and cholestasis type is the main clinical type of DILF. Patients with hepatic encephalopathy and hepatorenal syndrome tend to have poor prognosis.

     

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