■在重症监护病房(ICU)和非ICU设置中偶尔观察到极端高胆红素血症。这项研究检查了极端高胆红素血症(胆红素水平≥12mg/dL)的病因以及与30天死亡率相关的因素。
■这项回顾性观察性队列研究确定了2016年至2020年间庆尚国立大学昌原医院的439例极端高胆红素血症患者。根据病因将患者分为三组和11种疾病。使用Cox比例风险模型调查与基线时30天死亡率相关的危险因素。
■在439例极端高胆红素血症患者中,287、78和74分别在肝硬化/恶性肿瘤组中,缺血性损伤组,和良性肝胆胰腺病因学组,分别,相应的30天死亡率为42.9%,76.9%,和17.6%。导致高胆红素血症的最常见疾病是胰胆管恶性肿瘤(28.7%),其次是肝硬化(17.3%),肝细胞癌(10.9%),肝转移(8.4%)。高胆红素血症的病因,阻塞性黄疸,感染,白蛋白水平,肌酐水平,凝血酶原时间-国际标准化比率与30天死亡率独立相关.
■本研究提示ICU和非ICU环境中极端高胆红素血症的三种病因。极端高胆红素血症患者的预后在很大程度上取决于病因和阻塞性黄疸的存在。
UNASSIGNED: Extreme
hyperbilirubinemia is occasionally observed in intensive care unit (ICU) and non-ICU settings. This study examined the etiologies of extreme
hyperbilirubinemia (bilirubin level ≥12 mg/dL) and the factors associated with the 30-day mortality.
UNASSIGNED: This retrospective observational cohort study identified 439 patients with extreme hyperbilirubinemia at the Gyeongsang National University Changwon Hospital between 2016 and 2020. The patients were classified into three groups and 11 diseases according to their etiology. The risk factors associated with 30-day mortality at the baseline were investigated using the Cox proportional hazards model.
UNASSIGNED: Of 439 patients with extreme
hyperbilirubinemia, 287, 78, and 74 were in the liver cirrhosis/malignancy group, the ischemic injury group, and the benign hepatobiliary-pancreatic etiological group, respectively, with corresponding 30-day mortality rates of 42.9%, 76.9%, and 17.6%. The most common disease leading to hyperbilirubinemia was a pancreatobiliary malignancy (28.7%), followed by liver cirrhosis (17.3%), hepatocellular carcinoma (10.9%), and liver metastases (8.4%). The etiologies of
hyperbilirubinemia, obstructive jaundice, infection, albumin level, creatinine level, and prothrombin time-international normalized ratio were independently associated with the 30-day mortality.
UNASSIGNED: This study suggests three etiologies of extreme
hyperbilirubinemia in the ICU and non-ICU settings. The prognosis of patients with extreme hyperbilirubinemia depends largely on the etiology and the presence of obstructive jaundice.