Background
Methods
Data source and study population
Availability of data and materials
Statistical analysis
Results
Demographic and admission data of hospitalized patients with DILI
2009 | 2010 | 2011 | 2012 | 2013 | Average | |
---|---|---|---|---|---|---|
Annual admissions, n | 1,197 | 1,244 | 1,312 | 1,362 | 1,401 | 1,303 |
% of admissions (per liver diseases) | 4.2 | 4.1 | 4.1 | 4.1 | 4.0 | 4.1 |
% of admissions (per total admissions) | 0.11 | 0.11 | 0.12 | 0.12 | 0.13 | 0.12 |
Male, n (%) | 603 (50) | 634 (51) | 677 (52) | 720 (53) | 724 (52) | 671.6 (51.5) |
Age, years | 52.4 ± 18.5 | 52.2 ± 18.6 | 50.4 ± 18.5 | 52.7 ± 18.6 | 52.3 ± 18.8 | 52.0 ± 18.6 |
Length of hospital stay, days | 6.9 | 6.8 | 6.9 | 6.5 | 6.4 | 6.7 ± 6.7 |
Cost of hospitalization, USD | 443,230 | 535,600 | 545,650 | 565,661 | 579,636 | 533,955 ± 53,532 |
Mortality, n (%) | ||||||
‒ In-hospital mortality | 34 (2.8) | 44 (3.5) | 52 (4.0) | 47 (3.5) | 42 (3.0) | 43.8 (3.4) |
‒ 90 day mortality | 288 (24.0) | 251 (20.0) | 233 (18.0) | 202 (15.0) | 144 (10.0) | 223.6 (17.2) |
Drug or substance | Number | % |
---|---|---|
Acetaminophen (T39.1) | 206 | 35 |
Antimycobacterial drugs (T37.1 and T36.6) | 204 | 34.6 |
Other and unspecified drugs and substances (T50.9) | 34 | 5.8 |
Antiviral drugs (T37.5) | 22 | 3.7 |
Ingested mushroom (T62.0) | 16 | 2.7 |
Herbicides and fungicides (T60.3) | 13 | 2.2 |
Antihyperlipdemia and antiarteriosclerotic drugs (T46.6) | 7 | 1.2 |
Aminoglycosides (T36.5) | 6 | 1.0 |
Other antibiotics (T36.8) | 6 | 1.0 |
Other nonsteroidal anti-inflammatory drugs (T39.3) | 6 | 1.0 |
Local antifungal, anti-infective and anti-inflammatory drugs (T49.0) | 6 | 1.0 |
Others | 63 | 10.7 |
The risks of in-hospital and 90 day mortality
Country region | Number | % | In-hospital mortality (n) | In-hospital mortality rate (%) |
---|---|---|---|---|
Central | 703 | 11.4 | 36 | 5.1 |
Northeast | 2421 | 39.2 | 34 | 1.4 |
North | 588 | 9.5 | 24 | 4.1 |
South | 650 | 10.5 | 15 | 2.3 |
Other | 1311 | 21.2 | 56 | 4.3 |
Bangkok | 501 | 8.1 | 31 | 6.2 |
Totala | 6174 | 100.0 | 196 | 3.2 |
Hospital level | Number | % | In-hospital mortality (n) | In-hospital mortality rate (%) |
---|---|---|---|---|
Primary level | 2575 | 41.7 | 33 | 1.3 |
Secondary level | 1960 | 31.7 | 84 | 4.3 |
Tertiary level | 1639 | 26.5 | 79 | 4.8 |
Totala | 6174 | 100.0 | 196 | 3.2 |
The distribution of DILI types
Type of DILI | Number | % | In-hospital mortality (%) | 90-day mortality (%) |
---|---|---|---|---|
Cholestasis (K71.0) | 329 | 5.3 | 6.1 | 24.0 |
Hepatic necrosis (K71.1) | 1580 | 25.6 | 4.2 | 21.7 |
Acute hepatitis (K71.2) | 2072 | 33.5 | 2.2 | 17.3 |
Chronic persistent hepatitis (K71.3) | 29 | 0.5 | 3.5 | 24.1 |
Chronic lobular hepatitis (K71.4) | 13 | 0.2 | 7.7 | 30.8 |
Chronic active hepatitis (K71.5) | 7 | 0.1 | 0.0 | 42.9 |
Hepatitis, not elsewhere classified (K71.6) | 1685 | 27.3 | 2.7 | 19.5 |
Fibrosis and cirrhosis of liver (K71.7) | 57 | 0.9 | 15.8 | 47.4 |
Other disorders of liver (K71.8) | 46 | 0.7 | 2.2 | 30.4 |
Unspecified (K71.9) | 358 | 5.8 | 1.4 | 18.2 |
Total | 6176 | 100.0 | 3.2 | 19.9 |
Independent factors associate with mortality in patients having DILI
Univariate Cox regression | Multiple Cox regression | |||||
---|---|---|---|---|---|---|
Crude Hazard Ratio | 95 % CI | p | Adjusted Hazard Ratio | 95 % CI |
p
| |
Acetaminophen | 0.13 | 0.07–0.22 | <0.001 | 0.24 | 0.13–0.42 | <0.001 |
Cirrhosis | 2.60 | 2.24–3.02 | <0.001 | 2.72 | 2.33–3.19 | <0.001 |
Age ≥ 60 years | 1.74 | 1.61–1.89 | <0.001 | 2.16 | 1.96–2.38 | <0.001 |
HIV | 1.39 | 1.26–1.53 | <0.001 | 2.11 | 1.88–2.36 | <0.001 |
Chronic kidney diseases | 1.94 | 1.63–2.32 | <0.001 | 1.59 | 1.33–1.90 | <0.001 |
COPD/bronchiectasis | 1.92 | 1.46–2.53 | <0.001 | 1.55 | 1.17–2.04 | 0.002 |
Malnutrition | 1.87 | 1.44–2.42 | <0.001 | 1.43 | 1.10–1.86 | 0.007 |
Male | 1.41 | 1.29–1.53 | <0.001 | 1.31 | 1.21–1.43 | <0.001 |
Ascites | 2.17 | 1.56–3.02 | <0.001 | 1.40 | 0.97–1.98 | 0.052 |
Mushroom | 0.14 | 0.00–1.03 | 0.053 | 0.22 | 0.03–1.53 | 0.125 |