Patterns and Outcomes of Hepatic Dysfunction among Intensive Care Unit Patients: A Prospective Observational Study

Abstract

Background & Objectives: Acute liver dysfunction is a common reason for admission to the intensive care unit. This study was conducted to know the pattern of liver dysfunction and outcome in the semi-closed intensive care unit.

Materials and Methods: This descriptive cross-sectional study was conducted over 2 years in 982 patients aged ≥18 years who were admitted to the mixed intensive care unit of a tertiary care hospital for more than 24 hours with altered liver function tests. The outcomes of the patients were defined as being shifted to the ward, expired or left against medical advice. All data were transferred to an Excel sheet and to a statistical package for the social sciences version-20.

Results: Among 982 patients, 658(67%) were males and 324(33%) were females. All 982(100%) patients were community-acquired, and the majority, 968(98.5%), were admitted from the emergency having medical reasons, 962(98%) as a cause of acute liver dysfunction. The mean age, APACHE II, SOFA, MELD score, and duration of illness of the patients were 52.59±17.65 years, 4.45±7.4, 10.84± 6.84, 11.76± 7.91 and 2.5±1.63 days. 441(44.9%) developed a mixed type of acute liver dysfunction. Only 74(7.5%) cases underwent mechanical ventilation. 762(77.5%) patients were shifted to ward and 132(13.5%) expired. The mean length of stay and duration of mechanical ventilation were 3.66 ±1.78 and 2.1±0.94 days, respectively.

Conclusions: Medical causes (mostly Infective) were the most common cause of ICU admissions in patients who had liver dysfunction. Mixed type of liver dysfunction was more common in patients who developed acute liver dysfunction. The burden of acute liver dysfunction in critically ill patients admitted to our ICU is high.