Table 4. Comparison of patient characteristics between recovery and non-recovery groups.
| Recovery Group (N = 110, 25.8%) | Non-recovery Group (N = 317, 74.2%) | p-value | |
|---|---|---|---|
| Age (year, mean ± S.D.) | 58.20 ± 14.40 | 60.31 ± 13.79 | 0.173a |
| Sex | 0.455c | ||
| Male | 70 (24.5%) | 216 (75.5%) | |
| Female | 40 (28.4%) | 101 (71.6%) | |
| Alcohol drinking | 44 (40.0%) | 139 (43.8%) | 0.482c |
| Smoking | 40 (36.4%) | 132 (41.6%) | 0.331c |
| Comorbiditiy | |||
| Diabetes mellitus | 30 (27.3%) | 96 (30.3%) | 0.551c |
| Hypertension | 53 (48.2%) | 134 (42.3%) | 0.282c |
| Dyslipidemia | 5 (4.5%) | 21 (6.6%) | 0.432c |
| Chronic liver disease | 16 (14.5%) | 97 (30.6%) | 0.001c |
| Cancer | 0.004c | ||
| Yes | 57 (51.8%) | 213 (67.2%) | |
| None | 53 (48.2%) | 104 (32.8%) | |
| Hepatic encephalopathy | 4 (3.6%) | 31 (9.8%) | 0.043c |
| DIC | 49 (44.5%) | 206 (65.0%) | <0.001c |
| ACLF | 14 (12.7%) | 80 (25.2%) | 0.006c |
| Acute kidney injury | 86 (78.2%) | 279 (88.0%) | 0.012c |
| Chronic kidney disease | 23 (20.9%) | 54 (17.0%) | 0.362c |
| Sepsis | 58 (52.7%) | 196 (61.8%) | 0.094c |
| Shock | 58 (52.7%) | 211 (66.6%) | 0.010c |
| Septic | 43 (39.1%) | 144 (45.4%) | 0.249c |
| Cardiogenic | 11 (10.0%) | 21 (6.6%) | 0.247c |
| Hypovolemic | 8 (7.3%) | 43 (13.6%) | 0.080c |
| CPR | 19 (17.3%) | 45 (14.2%) | 0.436c |
| ECMO | 26 (25.5%) | 55 (16.9%) | 0.054c |
| Liver surgery | 7 (6.4%) | 14 (4.4%) | 0.416c |
| UDCA administration | 35 (31.8%) | 62 (19.6%) | 0.008c |
| Initial SOFA score | 9.34 ± 2.52 | 9.95 ± 2.29 | 0.018a |
| Number of dysfunctional organs | 3.68 ± 1.27 | 3.99 ± 1.09 | 0.023a |
| Peak bilirubin value (mg/dL) | 18.10 ± 6.71 | 25.19 ± 11.43 | <0.001a |
| Peak bilirubin grade | <0.001e | ||
| 1 (12–15) | 52 (46.8%) | 59 (53.2%) | |
| 2 (15–20) | 29 (29.3%) | 70 (70.7%) | |
| 3 (20–30) | 24 (18.3%) | 107 (81.7%) | |
| 4 (30-) | 5 (5.8%) | 81 (94.2%) | |
| Laboratory analyses (median (IQR)) | |||
| AST (IU/L) | 84.27 (42.18~207.25) | 136.09 (59.53~617.88) | <0.001b |
| ALT (IU/L) | 59.96 (29.46~193.44) | 82.19 (38.54~247.50) | 0.073b |
| ALP (IU/L) | 108.71 (78.92~163.33) | 129.00 (85.13~203.10) | 0.052b |
| GGT (IU/L) | 87.67 (53.07~205.00) | 76.17 (40.00~182.00) | 0.121b |
| INR | 1.43 (1.24~1.63) | 1.75 (1.51~2.25) | <0.001b |
| Albumin (g/dL) | 2.85 (2.59~3.03) | 2.77 (2.51~3.03) | 0.076b |
| CRP (mg/dL) | 11.23 (5.76~15.27) | 9.60 (5.34~15.45) | 0.402b |
| Lactate (mg/dL) | 2.46 (1.76~3.71) | 3.81 (2.70~6.53) | <0.001b |
| Cause of hyperbilirubinemiaf | |||
| Obstructive | 17 | 23 | |
| Stone | 6 (5.5%) | 8 (2.5%) | 0.209d |
| Stricture | 9 (8.2%) | 14 (4.4%) | 0.132c |
| Neoplasm | 2 (1.8%) | 1 (0.3%) | 0.164d |
| Non-obstructive | 203 | 611 | |
| Hypoxic hepatitis | 28 (25.5%) | 113 (35.6%) | 0.050c |
| Infection including sepsis | 70 (63.6%) | 200 (63.1%) | 0.919c |
| Primary liver disease | 12 (10.9%) | 103 (32.5%) | <0.001c |
| Traumatic or surgical liver injury | 4 (3.6%) | 10 (3.2%) | 0.762d |
| Pigment overload | 27 (24.5%) | 63 (19.9%) | 0.301c |
| Drug | 39 (35.5%) | 68 (21.5%) | 0.003c |
| Other organ failure-relation | 22 (20.0%) | 49 (15.5%) | 0.270c |
| Long-term NPO | 1 (0.9%) | 5 (1.6%) | 1.000d |
| Type of hyperbilirubinemia | 0.005c | ||
| Direct | 98 (28.7%) | 243 (71.3%) | |
| Indirect | 7 (11.5%) | 54 (88.5%) | |
| Hospital mortality | 32 (29.1%) | 293 (92.4%) | <0.001c |
SD: standard deviation; DIC: disseminated intravascular coagulation; ACLF: acute on chronic liver failure; CPR: cardio-pulmonary resuscitation; ECMO: extracorporeal membrane oxygenation; UDCA: ursodeoxycholic acid, SOFA, Sequential Organ Failure Assessment; IQR: interquartile range; IU: international unit; AST: aspartate aminotransferase; ALT: alanine aminotransferase; ALP: alkaline phosphatase; GGT: γ(gamma)-glutamyl transferase; INR: international normalized ratio; CRP: c-reactive protein; NPO: nil-per-os.
Recovery group: the patients whose serum bilirubin decreased below 6 mg/dL.
Non-recovery group: the patients whose serum bilirubin didn’t decrease below 6 mg/dL.
Chronic liver disease: liver cirrhosis, chronic viral hepatitis, alcoholic liver disease, autoimmune hepatitis, drug-induced and toxic hepatitis.
Initial SOFA score: the score of SOFA at ICU admission.
Laboratory analyses: median values of calculated means in each and every patient obtained during the 15 days before and after the first incidence of serum total bilirubin ≧ 12 mg/dL after ICU admission.
Cause of hyperbilirubinemia: the factor identified as two most important causes of extreme hyperbilirubinemia in each patient.
aIndependent T test
bMann-Whitney test
cChi-square test
dFisher’s exact test
eCochran-Armitage trend test
fCategorized multiple response analysis.