Table 2.
Comparison of Non-Hepatic Hyperammonemic Critical Care Patient Characteristics of Hospital Survivors and Non-Survivors
| Characteristic | Survivors (n=117) | Deceased (n=50) | p value |
|---|---|---|---|
|
| |||
| Age, median, yrs | 63(47–72) | 72(60–79) | 0.016 |
|
| |||
| Female sex, n (%) | 44(37) | 22(44) | 0.43 |
|
| |||
| Body Mass Index (kg/m2) groups | 0.23 | ||
| Underweight (<18.5) | 1(0.8) | 2(4) | |
| Normal (18.5–24.9) | 26(22) | 15(30) | |
| Overweight (>25) | 85(72) | 33(66) | |
|
| |||
| APACHE III score, median (IQR) | 68(58–85) | 92(73–127) | <0.01 |
| Serum ammonia, ug/dL median, (IQR) | 67(58–84) | 74(60–99) | 0.05 |
| Acute brain failure, n (%) | 87(74) | 32(64) | 0.17 |
|
| |||
| Potential causes | |||
| Metabolic | |||
| Carnitin palmitoyl transferase deficiency, n (%) | 1(0.8) | 0(0) | 0.51 |
| Ornithine transcarbamylase deficiency, n (%) | 1(0.8) | 2(4) | 0.16 |
| Other Urea cycle abnormality, n (%) | 1(0.8) | 2(4) | 0.16 |
| Nutrition/GI | |||
| Gastric bypass surgery, n (%) | 5(4.2) | 1(2) | 0.46 |
| Total parenteral nutrition, n (%) | 3(2.5) | 1(2) | 0.82 |
| Malnutrition, n (%) | 21(18) | 6(12) | 0.33 |
| Upper GI bleeding, n (%) | 6(5) | 2(4) | 0.73 |
| Lower GI bleeding, n (%) | 2(1.7) | 0(0) | 0.22 |
| Drugs | |||
| Valproate, n (%) | 14(12) | 3(6) | 0.24 |
| Carbamazepine, n (%) | 2(1.7) | 0(0) | 0.35 |
| Proton Pump Inhibitors, n (%) | 41(35) | 17(34) | 0.89 |
| Renal failure, n (%) *** | 53(45) | 29(58) | 0.13 |
| Generalized seizures, n (%) | 11(9) | 0(0) | 0.02 |
| Solid organ transplantation, n (%) | 1(0.8) | 3(6) | 0.04 |
| Aggressive hematologic tumors, n (%) ** | 6(5.1) | 13(26) | <0.001 |
|
| |||
| Treatment | |||
| Invasive mechanical ventilation, n (%) | 72(61) | 29(58) | 0.66 |
| Non-invasive Ventilation, n (%) | 47(40) | 18(36) | 0.61 |
| Lactulose, n (%) | 25(21) | 8(16) | 0.42 |
| Rifaximin, n (%) | 3(2.5) | 0(0) | 0.25 |
| Sodium Benzoate n (%) | 1(0.8) | 0(0) | 0.51 |
| Hemodialysis n (%) | 21(18) | 8(16) | 0.76 |
*
data are shown as median (IQR) or n (%)
**
Multiple myeloma, Myelodysplastic syndrome, Recurrent Burkitt’s lymphoma, Diffuse Large B-cell Lymphoma, Acute erythroblastic leukemia, Anaplastic large cell ALK-negative T-cell lymphoma, Relapsed T/NK cell acute lymphoblastic leukemia, Hodgkin’s lymphoma, NK/T cell Lymphoma, T-cell Lymphoma, Acute myeloid leukemia
***
Acute renal failure present in 44 patients (26.3%); chronic renal failure in 22 patients (13.2%); Acute-on-chronic renal failure in 16 patients (9.6%)