KaydedilenlerDerginizi ekleyin

Dergiler / Düzce Tıp Fakültesi Dergisi / 2026 / Volume: 28 Issue: 1

Frequency of Ischemic Hepatitis in Patients Presenting to the Emergency Department with a Diagnosis of Decompensated Heart Failure and Clinical Outcomes of Patients with Ischemic Hepatitis

Hasan Sultanoğlu(DUZCE UNIVERSITY, FACULTY OF MEDICINE)0000-0003-4099-572X
Sayfa
—
Yayın Tarihi
2026-04-25
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Prompt recognition and hemodynamic stabilization may improve survival outcomes.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Aim: Ischemic hepatitis (IH), also called hypoxic hepatitis, is a form of acute hepatocellular injury often seen in advanced heart failure (HF) with hemodynamic compromise.
📊
Temel Bulgular & Veri:Material and Methods: This retrospective study included adult patients aged ≥18 years with NYHA class III-IV decompensated HF who presented to the ED between January 2020 and January 2024.
💡
Sonuç & Katkı:Prompt recognition and hemodynamic stabilization may improve survival outcomes.
🔬Tür:Research Article
📍Kapsam:2020 Verileri
⚙️Değişkenler:Ischemic hepatitis · decompensated heart failure · emergency department

Abstract

Aim: Ischemic hepatitis (IH), also called hypoxic hepatitis, is a form of acute hepatocellular injury often seen in advanced heart failure (HF) with hemodynamic compromise. However, its prevalence and prognostic significance in emergency department (ED) patients with decompensated HF remain insufficiently defined. This study aimed to investigate the prevalence of IH, clinical and laboratory outcomes, intensive care unit (ICU) admission, and in-hospital mortality associated with IH in this patient group. Material and Methods: This retrospective study included adult patients aged ≥18 years with NYHA class III-IV decompensated HF who presented to the ED between January 2020 and January 2024. IH was defined as ≥10-fold elevation of AST and/or ALT above the upper normal limit after excluding alternative hepatocellular injury causes. Clinical, laboratory, ultrasonographic data, and outcomes were compared between IH (+) and IH (–) patients. Results: Among 378 patients, 45 (11.9%) developed IH. IH (+) patients had lower systolic/diastolic blood pressures and higher heart rates, along with significantly elevated AST, ALT, INR, bilirubin, troponin, and creatinine, but reduced albumin and sodium levels, compared with IH (–) patients (all p<0.001). ICU admission (75.6%, n=34) vs. (21.6%, n=72), and in-hospital mortality (35.6%, n=16) vs. (6.0%, n=20), were markedly higher in IH (+) patients (p<0.001). Multivariable analysis identified elevated transaminases, INR, bilirubin, troponin, and tachycardia as independent predictors of IH. Conclusion: IH is a relatively frequent yet severe complication in ED patients with advanced decompensated HF, strongly associated with increased ICU need and mortality. Prompt recognition and hemodynamic stabilization may improve survival outcomes.

🔖

Bu Makaleye Atıf Yap

Sultanoğlu, H. (2026). Frequency of Ischemic Hepatitis in Patients Presenting to the Emergency Department with a Diagnosis of Decompensated Heart Failure and Clinical Outcomes of Patients with Ischemic Hepatitis. Düzce Tıp Fakültesi Dergisi, Volume: 28 Issue: 1. https://doi.org/10.18678/dtfd.1768790

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (20)

  1. Fuhrmann V, Jäger B, Zubkova A, Drolz A. Hypoxic hepatitis - epidemiology, pathophysiology and clinical management. Wien Klin Wochenschr. 2010;122(5-6):129-39. doi:10.1007/s00508-010-1357-6.
  2. Van den Broecke A, Van Coile L, Decruyenaere A, Colpaert K, Benoit D, Van Vlierberghe H, et al. Epidemiology, causes, evolution and outcome in a single-center cohort of 1116 critically ill patients with hypoxic hepatitis. Ann Intensive Care. 2018;8(1):15. doi:10.1186/s13613-018-0356-z.
  3. Lightsey JM, Rockey DC. Current concepts in ischemic hepatitis. Curr Opin Gastroenterol. 2017;33(3):158-63. doi:10.1097/MOG.0000000000000355.
  4. Biegus J, Hillege HL, Postmus D, Valente MA, Bloomfield DM, Cleland JG, et al. Abnormal liver function tests in acute heart failure: relationship with clinical characteristics and outcome in the PROTECT study. Eur J Heart Fail. 2016;18(7):830-9. doi:10.1002/ejhf.532.
  5. Fuhrmann V, Kneidinger N, Herkner H, Heinz G, Nikfardjam M, Bojic A, et al. Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients. Intensive Care Med. 2009;35(8):1397-405. doi:10.1007/s00134-009-1508-2.
  6. Møller S, Bernardi M. Interactions of the heart and the liver. Eur Heart J. 2013;34(36):2804-11. doi:10.1093/eurheartj/eht246.
  7. Birrer R, Takuda Y, Takara T. Hypoxic hepatopathy: pathophysiology and prognosis. Intern Med. 2007;46(14):1063-70. doi:10.2169/internalmedicine.46.0059.
  8. Henrion J. Hypoxic hepatitis. Liver Int. 2012;32(7):1039-52. doi:10.1111/j.1478-3231.2011.02655.x.
  9. Beer BN, Besch L, Weimann J, Surendra K, Roedl K, Grensemann J, et al. Incidence of hypoxic hepatitis in patients with cardiogenic shock and association with mortality. Eur Heart J Acute Cardiovasc Care. 2023;12(10):663-70. doi:10.1093/ehjacc/zuad076.
  10. Abdel-Razek O, Jung RG, Di Santo P, Mathew R, Hibbert B. Impact of hypoxic hepatitis in cardiogenic shock: a substudy of the DOREMI trial. Eur Heart J Open. 2024;4(3):oeae024. doi:10.1093/ehjopen/oeae024.
  11. Raurich JM, Llompart-Pou JA, Ferreruela M, Colomar A, Molina M, Royo C, et al. Hypoxic hepatitis in critically ill patients: incidence, etiology and risk factors for mortality. J Anesth. 2011;25(1):50-6. doi:10.1007/s00540-010-1058-3.
  12. Tapper EB, Sengupta N, Bonder A. The incidence and outcomes of ischemic hepatitis: a systematic review with meta-analysis. Am J Med. 2015;128(12):1314-21. doi:10.1016/j.amjmed.2015.07.033.
  13. Sokolska JM, Sokolski M, Zymliński R, Biegus J, Siwołowski P, Nawrocka-Millward S, et al. Patterns of dyspnoea onset in patients with acute heart failure: clinical and prognostic implications. ESC Heart Fail. 2019;6(1):16-26. doi:10.1002/ehf2.12371.
  14. Samsky MD, Patel CB, DeWald TA, Smith AD, Felker GM, Rogers JG, et al. Cardiohepatic interactions in heart failure: an overview and clinical implications. J Am Coll Cardiol. 2013;61(24):2397-405. doi:10.1016/j.jacc.2013.03.042.
  15. Hyun J, Cho JY, Youn JC, Kim D, Cho DH, Park SM, et al. Korean Society of Heart Failure guidelines for the management of heart failure: advanced and acute heart failure. Int J Heart Fail. 2023;5(3):111-26. doi:10.36628/ijhf.2023.0019.
  16. Natarajaboobathy R, Balaraman B. A study on hepatic dysfunction and its prognostic significance in acute decompensated heart failure. European Journal of Cardiovascular Medicine. 2023;13(3):1457-60. doi:10.5083/ejcm/2023.
  17. Waseem N, Chen PH. Hypoxic hepatitis: a review and clinical update. J Clin Transl Hepatol. 2016;4(3):263-8. doi:10.14218/JCTH.2016.00022.
  18. Waskowski J, Michel MC, Steffen R, Messmer AS, Pfortmueller CA. Fluid overload and mortality in critically ill patients with severe heart failure and cardiogenic shock-An observational cohort study. Front Med (Lausanne). 2022;9:1040055. doi:10.3389/fmed.2022.1040055.
  19. Macerola N, Riccardi L, Di Stasio E, Montalto M, Gasbarrini A, Pompili M, et al. Prognostic value of liver stiffness in patients hospitalized for acute decompensated heart failure: a meta-analysis. J Ultrasound. 2024;27(3):551-7. doi:10.1007/s40477-024-00873-0.
  20. Thawabi M, Hawatmeh A, Studyvin S, Habib H, Shamoon F, Cohen M. Cardiac troponin and outcome in decompensated heart failure with preserved ejection fraction. Cardiovasc Diagn Ther. 2017;7(4):359-66. doi:10.21037/cdt.2017.03.17.