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Je něco špatně v tomto záznamu ?
Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock
T. Jäntti, T. Tarvasmäki, VP. Harjola, J. Parissis, K. Pulkki, A. Sionis, J. Silva-Cardoso, L. Køber, M. Banaszewski, J. Spinar, V. Fuhrmann, J. Tolonen, V. Carubelli, S. diSomma, A. Mebazaa, J. Lassus, . ,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie
NLK
ProQuest Central
od 2012-08-15 do Před 2 měsíci
Nursing & Allied Health Database (ProQuest)
od 2012-08-15 do Před 2 měsíci
Health & Medicine (ProQuest)
od 2012-08-15 do Před 2 měsíci
- MeSH
- alanintransaminasa krev MeSH
- alkalická fosfatasa krev MeSH
- incidence MeSH
- jaterní testy statistika a číselné údaje MeSH
- kardiogenní šok krev komplikace mortalita MeSH
- lidé MeSH
- míra přežití MeSH
- nemoci jater diagnóza epidemiologie etiologie MeSH
- prevalence MeSH
- prognóza MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
Cardiogenic shock (CS) is a cardiac emergency often leading to multiple organ failure and death. Assessing organ dysfunction and appropriate risk stratification are central for the optimal management of these patients. The purpose of this study was to assess the prevalence of abnormal liver function tests (LFTs), as well as early changes of LFTs and their impact on outcome in CS. We measured LFTs in 178 patients in CS from serial blood samples taken at 0 hours, 12 hours, and 24 hours. The associations of LFT abnormalities and their early changes with all-cause 90-day mortality were estimated using Fisher's exact test and Cox proportional hazards regression analysis. Baseline alanine aminotransferase (ALT) was abnormal in 58% of the patients, more frequently in nonsurvivors. Abnormalities in other LFTs analyzed (alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin) were not associated with short-term mortality. An increase in ALT of >20% within 24 hours (ΔALT>+20%) was observed in 24% of patients. ΔALT>+20% was associated with a more than 2-fold increase in mortality compared with those with stable or decreasing ALT (70% and 28%, p <0.001). Multivariable regression analysis showed that ΔALT>+20% was associated with increased 90-day mortality independent of other known risk factors. In conclusion, an increase in ALT in the initial phase was seen in 1/4 of patients in CS and was independently associated with 90-day mortality. This finding suggests that serial ALT measurements should be incorporated in the clinical assessment of patients in CS.
Department of Anesthesia and Critical Care Hôpital Lariboisière APHP Paris France
Department of Intensive Care Medicine University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic
Heart Failure Clinic Secondary Cardiology Department Attikon University Hospital Athens Greece
INSERM U942 University Paris Diderot Paris France
Intensive Cardiac Therapy Clinic Institute of Cardiology Warsaw Poland
Citace poskytuje Crossref.org
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- $a Jäntti, Toni $u Internal Medicine, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland. Electronic address: toni.jantti@fimnet.fi.
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- $a Cardiogenic shock (CS) is a cardiac emergency often leading to multiple organ failure and death. Assessing organ dysfunction and appropriate risk stratification are central for the optimal management of these patients. The purpose of this study was to assess the prevalence of abnormal liver function tests (LFTs), as well as early changes of LFTs and their impact on outcome in CS. We measured LFTs in 178 patients in CS from serial blood samples taken at 0 hours, 12 hours, and 24 hours. The associations of LFT abnormalities and their early changes with all-cause 90-day mortality were estimated using Fisher's exact test and Cox proportional hazards regression analysis. Baseline alanine aminotransferase (ALT) was abnormal in 58% of the patients, more frequently in nonsurvivors. Abnormalities in other LFTs analyzed (alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin) were not associated with short-term mortality. An increase in ALT of >20% within 24 hours (ΔALT>+20%) was observed in 24% of patients. ΔALT>+20% was associated with a more than 2-fold increase in mortality compared with those with stable or decreasing ALT (70% and 28%, p <0.001). Multivariable regression analysis showed that ΔALT>+20% was associated with increased 90-day mortality independent of other known risk factors. In conclusion, an increase in ALT in the initial phase was seen in 1/4 of patients in CS and was independently associated with 90-day mortality. This finding suggests that serial ALT measurements should be incorporated in the clinical assessment of patients in CS.
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