An investigation of early prognostic factor of sepsis-associated liver injury

Abstract

We retrospectively investigated the clinical features of sepsis-associated liver injury in Teikyo University Mizonokuchi Hospital and examined which factors useful to predict prognosis in an early onset. In 116 patients with sepsis, 61 cases (52.6％) were diagnosed as sepsis-associated liver injury. Mortality rate was higher in patients having sepsis-associated liver injury. The concurrence of DIC was more frequent in the cases of sepsis-associated liver injury than in septic cases without liver injury. Interestingly, serum levels of FDP and D-dimer were higher in the cases of sepsisassociated liver injury even though without DIC. Ten cases including three cases of MRSA infection presented jaundice and died. As for the fatal cases, serum levels of ALP and γ-GTP were significantly higher than those of survivors. In a multivariate analysis, high ALP level was the only convaleacence prediction factor in the sepsis-associated liver injury. These results suggest that high serum levels of ALP and γ-GTP and detection of MRSA are useful to predict poor prognosis of sepsis-associated liver injury in an early stage.