Abstract: Objective To investigate the etiology and clinical features of elderly patients with drug-induced liver injury (DILI). Methods A total of 162 patients with DILI admitted to our hospital from June 2014 to December 2020 were selected, and their clinical data were retrospectively analyzed. The Roussel Uclaf Causality Assessment Method (RUCAM) was used to evaluate the relationship between drugs and liver injury. The suspected drugs related to DILI, the clinical manifestations and clinical features of DILI were also analyzed. Results The youngest patient was 68 years old and the oldest was 96, the average age was 91.2. The drugs most likely to induce DILI were Chinese herbal medicine and Chinese patent medicine (68 cases, 41.98%), antibiotic (21 cases, 12.96%) and cardiovascular drugs (13 cases, 8.02%), the RUCAM grades were all more than 3, and there was no significant difference in clinical manifestations among the patients with DILI induced by the three drugs. The numbers of cholestatic injury type, hepatocellular injury type and mixed injury type were 76 (46.91%), 48 (29.63%), 38 (23.46%), respectively. The proportion of severity grade 1, 2, 3 and 4 were 46.29%, 32.72%, 13.58%, 7.41% respectively. Conclusion In the study, we find that traditional Chinese medicine is the main cause of DILI in elder patients, which is worthy of high attention. Clinical manifestations are not significantly different. The most common type is cholestatic DILI. Early intervention can improve the prognosis of patients.

Key words: Drug-induced liver injury, Advanced age, Clinical features