Risk factors related to significant hepatic inflammation in patients with acute drug-induced liver injury

作者：Yüting Xiong, Jianfei Wang, Le Li, Zhifang Bai, Yan Liu, Ang Huang, Kexin Wang, Yiming Fu, Wucai Yang, Chang Guo, M. L. He, Wen‐Chang Wang, Chunyan Wang, Dong Ji · 发表于：iLiver · 年份：2024 · DOI：10.1016/j.iliver.2024.100095 · 被引用次数：6 · 研究领域：Drug-Induced Hepatotoxicity and Protection、Hepatitis C virus research、Liver Disease Diagnosis and Treatment

Currently, research on biopsy-proven acute drug-induced liver injury (DILI) remains limited. This study aimed to identify clinical characteristics and risk factors for significant hepatic inflammation in patients with acute DILI. An ambispective cohort study was conducted on biopsy-proven acute DILI patients admitted to our hospital from 2012 to 2018. Using the Scheuer scoring system, patients were categorized into G0-2 or G3-4 groups and followed up for 12 months after first admission. Clinical characteristics and outcomes were retrieved from medical records. The median age of the 157 enrolled patients (65.6% female) was 40.4 (interquartile range (IQR), 31.9–49.1) years. The median latency and length of hospitalization were 30.0 (IQR, 5.0–60.0) and 18.0 (IQR, 12.0–26.0) days. The proportions of patients in the G0-2 and G3-4 groups were 54.8% and 45.2%, respectively. Logistic regression analysis revealed that females (odds ratio (OR): 2.623, 95% confidence interval (CI): 1.169–5.887, p = 0.019), higher body mass index (OR: 1.168, 95% CI: 1.029–1.325, p = 0.016), higher total bilirubin (OR: 1.004, 95% CI: 1.000–1.007, p = 0.047), and lower prothrombin activity (OR: 0.976, 95% CI: 0,957–0.995, p = 0.013) were associated with significant hepatic inflammation. The predominance of the hepatocellular injury pattern (60.5%) at admission transformed into a predominance of the cholestatic pattern (60.5%) at discharge. During follow-up, 23 patients (14.6%) developed chronic DILI, with ...