Influence of comorbidity on severity and prognosis of patients with DILI

Abstract

Abstract: Objective To investigate the influence of comorbidity on severity and prognosis of patients with drug-induced liver injury (DILI).Methods DILI patients admitted to our hospital from January 2016 to December 2019 who met the inclusion criteria were enrolled. According to Charlson Comorbidity Index (CCI), they were divided into significant comorbidity group (CCI≤2) and none or mild comorbidity group (CCI > 2). The clinical characteristics, severity and prognosis between the 2 groups were analyzed by chi-square or non-parametric test.Results A total of 313 DILI patients were included, with an average age of 54±14 years, 227 of them were females (72.5%). There were 272 patients with mild or without comorbidity (86.9%) and 41 patients with significant comorbidity (13.1%). Compared with patients with mild or without comorbidity, patients with significant comorbidity were significantly older (63±8 vs 52±14), and had higher body mass index (24.2±5.2 vs 23.1±3.6) , higher gamma-glutamyl transferase (GGT) level [initial value: 283.0 (159.0-404.0) vs 189.0 (100.0-325.0), higher peak value [335.0 (239.0-582.0) vs 219.0 (131.0-360.0) ] (all P<0.05. There was no significant difference in severity and clinical classification between 2 groups. In this cohort, 250 (79.9%) patients were fully recovered, whereas 41 (13.1%) patients developed to chronic DILI and 22 (7.0%) patients underwent liver transplantation or death. Compared to none or mild comorbidity group, the all-cause mortality and non-liver related mortality were significant higher in significant comorbidity group (19.5% vs 3.7%; 12.2% vs 0.7% all P<0.01).Conclusion Patients with significant comorbidity had poor prognosis, the leading cause of death is non-liver related.

Key words: Drug-induced liver injury, Charlson Comorbidity Index, Severity, Prognosis

WU Ting, WANG Yan, LIU Li-wei, LI Ke-xin, WANG Yu, OU Xiao-juan, JIA Ji-dong, ZHAO Xin-yan, MA Hong. Influence of comorbidity on severity and prognosis of patients with DILI[J]. Chinese Hepatolgy, 2022, 27(1): 23-27.

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