Table 2.
Characteristics of patients by cholestatic liver injury.
| Characteristic | Overall, N = 279 (100%)∗ | No cholestatic liver injury, n = 245 (88%)∗ | Cholestatic liver injury, n = 34 (12%)∗ | p value† |
|---|---|---|---|---|
| Male sex | 176 (63.1) | 154 (62.9) | 22 (64.7) | 0.834 |
| Age (years) | 50.7 (31.4–67.3) | 50.6 (31.0–68.1) | 50.8 (36.0–63.2) | 0.994 |
| BMI (kg/m2) | 25.1 (22.9–28.7) | 24.8 (22.9–28.5) | 26.1 (23.2–29.3) | 0.276 |
| Electrical burn | 14 (5.0) | 14 (5.7) | 0 (0.0) | 0.231 |
| Thermal burn | 268 (96.1) | 235 (95.9) | 33 (97.1) | >0.999 |
| Body surface area burned (%) | 28.5 (20.0–45.0) | 25.0 (20.0–40.0) | 42.5 (30.0–61.5) | 0.002 |
| Full-thickness body surface area burned (%) | 15.0 (5.0–27.8) | 13.5 (4.0–25.0) | 30.0 (15.0–52.0) | <0.001 |
| Inhalation injury | 91 (32.6) | 67 (27.3) | 24 (70.6) | <0.001 |
| ABSI | 8.0 (6.0–10.0) | 8.0 (6.0–9.0) | 10.0 (7.0–11.0) | <0.001 |
| SAPS II | 29.0 (19.0–41.0) | 28.0 (18.0–40.0) | 38.0 (31.0–46.0) | <0.001 |
| SOFA | 2.0 (0.0–6.0) | 2.0 (0.0–5.0) | 7.0 (3.8–9.3) | <0.001 |
| Volume expansion with crystalloid fluids (ml/kg/%) | 4.0 (2.4–5.3) | 3.9 (2.2–5.0) | 4.9 (4.0–6.0) | 0.032 |
| Vasopressors administration at admission | 108 (39.0) | 85 (35.0) | 23 (67.6) | <0.001 |
| Length of vasopressors infusion (days) | 1.0 (0.0–3.8) | 1.0 (0.0–2.0) | 9.0 (2.0–17.8) | <0.001 |
| Mechanical ventilation at admission | 173 (62.0) | 140 (57.1) | 33 (97.1) | <0.001 |
| Duration of mechanical ventilation (days) | 3.0 (0.0–31.0) | 2.0 (0.0–26.0) | 36.0 (18.5–67.5) | <0.001 |
| Initial AST level ( × ULN) | 0.9 (0.7–1.4) | 0.9 (0.7–1.4) | 1.2 (0.8–1.6) | 0.615 |
| Initial ALT level ( × ULN) | 0.7 (0.5–1.1) | 0.7 (0.5–1.0) | 0.8 (0.5–1.2) | 0.272 |
| Initial GGT level ( × ULN) | 0.6 (0.4–1.3) | 0.6 (0.3–1.2) | 0.6 (0.4–1.9) | 0.097 |
| Initial ALP level ( × ULN) | 0.6 (0.5–0.7) | 0.6 (0.5–0.7) | 0.6 (0.5–0.8) | 0.150 |
| Initial TBIL level ( × ULN) | 0.7 (0.4–1.1) | 0.7 (0.4–1.0) | 0.9 (0.4–1.3) | 0.277 |
| Initial prothrombin ratio (%) | 79.0 (64.0–89.0) | 80.0 (66.0–89.0) | 69.0 (46.5–83.0) | 0.013 |
| Initial serum creatinine level (μmol/L) | 71.5 (57.8–93.8) | 70.0 (57.1–89.2) | 86.0 (68.1–118.0) | 0.028 |
| Enteral nutrition | 188 (67.4) | 158 (64.5) | 30 (88.2) | 0.006 |
| Parenteral nutrition | 18 (6.5) | 8 (3.3) | 10 (29.4) | <0.001 |
| Acute kidney injury | 96 (34.4) | 70 (28.6) | 26 (76.5) | <0.001 |
| Renal replacement therapy | 39 (14.0) | 19 (7.8) | 20 (58.8) | <0.001 |
| Acute respiratory distress syndrome | 65 (23.3) | 44 (18.0) | 21 (61.8) | <0.001 |
| Septic shock | 76 (27.2) | 53 (21.6) | 23 (67.6) | <0.001 |
| Ketamine dose reduction period | 0.003 | |||
| Before reduction | 155 (55.6) | 128 (52.2) | 27 (79.4) | |
| After reduction | 124 (44.4) | 117 (47.8) | 7 (20.6) | |
| Total ketamine exposure (mg) | 43.5 (0.0–624.1) | 30.0 (0.0–354.0) | 9,936.2 (70.0–19,547.2) | <0.001 |
| Ketamine dose exposure distribution (mg) | <0.001 | |||
| [-Inf, 0] | 106 (38.0) | 100 (40.8) | 6 (17.6) | |
| (0, 1,000] | 106 (38.0) | 100 (40.8) | 6 (17.6) | |
| (1,000, 10,000] | 33 (11.8) | 28 (11.4) | 5 (14.7) | |
| (10,000, Inf] | 34 (12.2) | 17 (6.9) | 17 (50.0) | |
| Length of ketamine infusion (days) | 1.0 (0.0–6.0) | 1.0 (0.0–4.0) | 8.5 (2.3–20.8) | <0.001 |
| Time to ketamine exposure >1,000 mg | 2.0 (1.0–2.0) | 2.0 (1.0–2.5) | 2.0 (1.0–2.0) | 0.639 |
| Time to ketamine exposure >10,000 mg | 6.0 (5.0–8.8) | 6.0 (4.5–7.0) | 6.0 (5.5–13.0) | 0.285 |
| Number of patients without ketamine infusion | 107 (38.4) | 101 (41.2) | 6 (17.6) | 0.008 |
| Total midazolam exposure (mg) | 5.8 (0.0–461.3) | 2.0 (0.0–327.9) | 539.6 (234.2–1,526.1) | <0.001 |
| Length of midazolam infusion (days) | 1.0 (0.0–4.0) | 1.0 (0.0–4.0) | 6.0 (3.0–10.0) | <0.001 |
| Number of patients without midazolam infusion | 121 (43.4) | 116 (47.3) | 5 (14.7) | <0.001 |
| Total sufentanil exposure (μg) | 170.9 (0.0–2,592.9) | 90.0 (0.0–1,735.8) | 3,247.3 (685.2–4,967.1) | <0.001 |
| Length of sufentanil infusion (days) | 3.0 (0.0–14.0) | 2.0 (0.0–12.0) | 12.5 (6.3–27.5) | <0.001 |
| Number of patients without sufentanil infusion | 77 (27.6) | 75 (30.6) | 2 (5.9) | 0.003 |
| Length of stay in the ICU (days) | 30.0 (14.5–48.5) | 28.0 (13.0–46.0) | 55.0 (27.3–91.0) | <0.001 |
| 28-day mortality | 43 (15.5) | 35 (14.3) | 8 (23.5) | 0.165 |
| 90-day mortality | 57 (20.5) | 43 (17.6) | 14 (41.2) | 0.001 |
Cholestatic liver injury was serum ALP ≥1.5 × ULN with GGT ≥3 × ULN and TBIL >1 × ULN. The SAPS II ranges from 0 to 163, with higher scores indicating greater severity of illness. The ABSI ranges from 0 to 18, with higher scores indicating a greater probability of death after burn injury. The SOFA ranges from 0 to 24, with higher scores indicating more severe organ failure.
ABSI, abbreviated burn severity index; ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBIL, total bilirubin; GGT, gamma glutamyl transferase; ICU, intensive care unit; Inf, infinite; SAPS II, Simplified Acute Physiology Score II; SOFA, Sequential Organ Failure Assessment; ULN, upper limit of normal.
∗
Data are presented as n (%) or median (IQR).
†
Pearson’s Chi-squared test, the Wilcoxon rank sum test, or Fisher’s exact test.