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Medical Science Technology is an open access, peer-reviewed journal that is dedicated to publishing research in all areas of applied technology in medicine and biomedical research. It is aimed at readers and authors with their main interest in the application of technology to solve problems in the medical and biological sciences, and overlapping areas of medicine and technology, such as (but not limited... read more

Published: 2016-12-23

Sepsis-Induced Cholestasis is Associated with Increased Rates of Complications and 1-Year Mortality in Patients with Liver Cirrhosis

Juan-Juan Wu, He-Bin Fan, Ya-Bing Guo, Dong-Liang Yang, Chang-Li Zhang, Jun Xiao, Jie Sun, Lu Huang, Zhi Li, Li-Tong Xu, Fu-Ming Yan

(Department of Infectious Diseases, The People’s Liberation Army 161 Hospital, Wuhan, Hubei, China (mainland))

Med Sci Tech 2016; 57:116-121

DOI: 10.12659/MST.902027

BACKGROUND: Patients with liver cirrhosis are prone to bacterial infection. However, the occurrence of sepsis-induced cholestasis in cirrhotic patients has been seldom reported. The objectives of this study were to investigate sepsis-induced cholestasis in liver cirrhosis and its correlation with complications and short-term mortality.
MATERIAL AND METHODS: We screened 1028 consecutive patients with liver cirrhosis for cholestasis. Cholestasis was defined as total plasma bilirubin levels >3 mg/dL.
RESULTS: Of the 704 patients meeting the inclusion criteria, 134 patients (21.3%) developed cholestasis. The control group consisted of 570 patients who had sepsis but did not develop cholestasis. Of the 134 patients who developed cholestasis, sepsis was a major factor (n=58, 43.3%). Other causes of cholestasis included viral hepatitis (n=42, 31.3%), drug hepatotoxicity (n=23, 17.2%), and unknown reasons (n=11, 8.2% p=0.000). Among them, one-year mortality rate was significantly higher in the sepsis-induced cholestasis group compared to the control group (15.5% vs. 4.9%, p=0.000). Eighteen (31%) patients with sepsis-induced cholestasis developed at least 1 complication, as compared to 57 (10%) patients in the control group (P=0.021).
CONCLUSIONS: Sepsis was a major cause of cholestasis. Since cholestasis per se contributes to hepatic encephalopathy, as well as renal and GI complications; prevention and treatment of infection could reduce the development of complications and the death rate in patients with liver cirrhosis.

Keywords: Cholestasis, Liver Cirrhosis, Sepsis

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