Abstract: Objective To retrospectively analyze the changes in the etiology of severe hepatitis patients in our hospital over the past 30 years, as well as the clinical characteristics and prognosis differences in different years and etiologies. Methods Clinical data of 821 patients with severe hepatitis admitted to our hospital from February 1995 to January 2024 were collected. They were divided into three groups (Group A, B, and C) based on their year of hospitalization, and their pathogenic factors, clinical types, and survival rates were compared and analyzed. Results Before 2015, the main etiology of severe hepatitis was hepatitis B virus infection, accounting for 71.6%. In the past 10 years, alcoholic, drug-induced, and immunological severe hepatitis were the most common, accounting for 30.9%, 24.2%, and 10.9%, respectively, with statistically significant differences (P<0.05). The pathogenic factors are different, and there are significant differences in clinical types. The main cause of HBV virus was chronic and acute severe hepatitis, accounting for 73.0%. Acute and subacute severe hepatitis were mainly caused by other viruses and drugs, accounting for 50.7% and 50.6%, respectively. Alcohol, immune, and metabolic factors were mostly manifested as chronic and acute severe hepatitis, accounting for 67.5%, 61.8%, and 44.8%, respectively, with statistical significance (P<0.05). Conclusion Over the past 30 years, the incidence of severe hepatitis has gradually decreased, and common pathogenic factors have shifted from viruses to alcohol, drugs, and immunity. With the diversification and updating of treatment methods, patient survival rates have been increasing year by year.

Key words: Severe hepatitis, Pathogenic factors, Survival rate, Retrospective study