Inpatient admissions for drug-induced liver injury: Results from a single center

Elizabeth J. Carey, Hugo E. Vargas, David D. Douglas, Vijayan Balan, Thomas J. Byrne, M. Edwyn Harrison, Jorge Rakela

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Objective: To review all cases of drug-induced liver injury (DILI) requiring hospitalization at a single tertiary care center. Methods: Patient records were identified by ICD-9 codes for inpatient visits from November 1998 through March 2006. Results: Of a total 83,265 hospital admissions during the study period, 40 were for DILI (0.048%). Thirteen patients had non-acetaminophen DILI (NA-DILI); 27 had acetaminophen-related DILI (A-DILI). In the NA-DILI group, mean age was 59 ± 17.9 years and liver injury was classified as hepatocellular (7), cholestatic (5), or mixed (1). A variety of medications were implicated with antimicrobials being the most common class. Resolution occurred in seven, two died of complications related to hepatotoxicity, one underwent liver transplantation, and the outcome was undetermined in three who were lost to follow-up. In the A-DILI group, mean age was 35 ± 11.0 years. Eighteen involved intentional overdose of acetaminophen; nine were associated with chronic use. The pattern of injury was hepatocellular in all. Resolution occurred in 4 patients, death in 8, and improvement in 15. Conclusions: DILI is a rare cause of inpatient admission but is associated with significant mortality. Spontaneous resolution occurs in most patients but return to normal liver function may take months. Antimicrobial agents account for the largest proportion of NA-DILI.

Original languageEnglish (US)
Pages (from-to)1977-1982
Number of pages6
JournalDigestive Diseases and Sciences
Volume53
Issue number7
DOIs
StatePublished - Jul 1 2008

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Keywords

  • Drug-induced liver injury
  • Fulminant hepatic failure
  • Hepatotoxicity

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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