Abstract 280: Incidence of Hypoxic Liver Injury Among Out of Hospital Cardiac Arrest Survivors Treated in a Comprehensive Post Resuscitation Program
Background: Hypoxic liver injury (HLI) is associated with significant morbidity and mortality in critically ill patients. We sought to determine the incidence and mortality impact of HLI in out of hospital cardiac arrest (OHCA) patients treated in a comprehensive post-resuscitation program (CPRP).
Methods: We evaluated 136 adult patients with, non-traumatic, OHCA surviving to hospital admission and treated with a CPRP, including hypothermia, between March 1, 2004 and October 29, 2009. Data was analyzed retrospectively including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) values on presentation and during the hospital course. Patients demonstrating a 20-fold increase in two of the three measured liver enzymes within 48 hours of an episode of hypotension were considered to have HLI.
Results: Nine (7%) patients developed HLI during their hospital course within 48 hours of OHCA (mean peak AST 5551 units/L [95% CI 1965–9138]; ALT 3254 units/L [1634–4873]; ALP 141 units/L [103–180]). There was no difference in mean age, sex, medical history, presenting rhythm, down time interval, rate of witnessed arrest, or bystander CPR between the HLI and non-HLI groups. Overall survival to discharge was (43.7%), however, HLI patients were less likely to survive than non-HLI patients (1 vs 59, p =0.039).
Conclusions: HLI occurs infrequently among OHCA patients being treated in a CPRP and is unrelated to downtime interval. The presence of HLI is associated with worse survival.
- © 2010 by American Heart Association, Inc.