Systemic inflammatory response syndrome strongly affects the prognosis of patients with fulminant hepatitis B

Yasuhiro Miyake, Yoshiaki Iwasaki, Ryo Terada, Kouichi Takaguchi, Kohsaku Sakaguchi, Yasushi Shiratori

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Hepatitis B virus infection is the most frequent cause of fulminant hepatic failure. Recently, systemic inflammatory response syndrome has been reported to be important in patients with fulminant hepatic failure. However, prognostic factors for fulminant hepatitis B have not been fully examined. In this study, we analyzed prognostic factors for fulminant hepatitis B in order to accurately identify patients with fatal outcomes. Methods: Of 110 consecutive patients with fulminant hepatic failure, 36 (33%) were diagnosed with fulminant hepatitis B. Five of the 36 patients received liver transplants, and we analyzed prognostic factors associated with fatal outcomes in the other 31 patients, who consisted of 15 men and 16 women with a median age of 45 (range, 20-74) years. Results: Eleven patients (35%) survived without liver transplantation, and the remaining 20 (65%) died. Nonsurvivors were older and had a higher prevalence ratio of systemic inflammatory response syndrome than survivors. Treatments were similar between survivors and nonsurvivors. Using a multivariate Cox proportional hazard model, age (>45 years), systemic inflammatory response syndrome, and ratio of total to direct bilirubin (>2.0) were associated with fatal outcomes. In particular, 1-week and overall survival rates of patients with systemic inflammatory response syndrome at the time of diagnosis were 39% and 8%, respectively, while those of patients without systemic inflammatory response syndrome were 94% and 56%, respectively. Conclusions: Systemic inflammatory response syndrome strongly affects the short-term prognosis of patients with fulminant hepatitis B, and patients with systemic inflammatory response syndrome might need urgent liver transplantation.

Original languageEnglish
Pages (from-to)485-492
Number of pages8
JournalJournal of Gastroenterology
Volume42
Issue number6
DOIs
Publication statusPublished - Jun 2007

Keywords

  • Fulminant hepatitis B
  • Ratio of total to direct bilirubin
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Gastroenterology

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