Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury
Aims. The aim of this study was to assess the prognostic value of the serum total bilirubin (TBIL) level in pediatric patients with sepsis-associated liver injury (SALI). Methods. We performed a retrospective study of patients with SALI admitted to the pediatric intensive care unit (PICU) in Shangha...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2018/4591729 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560800630308864 |
|---|---|
| author | Yun Cui Yijun Shan Rongxin Chen Chunxia Wang Yucai Zhang |
| author_facet | Yun Cui Yijun Shan Rongxin Chen Chunxia Wang Yucai Zhang |
| author_sort | Yun Cui |
| collection | DOAJ |
| description | Aims. The aim of this study was to assess the prognostic value of the serum total bilirubin (TBIL) level in pediatric patients with sepsis-associated liver injury (SALI). Methods. We performed a retrospective study of patients with SALI admitted to the pediatric intensive care unit (PICU) in Shanghai Children’s Hospital between December 2012 and December 2015. Serum TBIL concentration was determined within 72 h after PICU admission. Results. Seventy-two patients with SALI were included in this study. The overall mortality rate was 36.1% (26/72). The serum levels of TBIL of patients were significantly higher in the nonsurvivor group than the survivor group. Cox regression analysis indicated that the elevated serum TBIL level within 72 hours after admission was an independent risk factor of mortality in patients with SALI. Furthermore, the area under the receiver-operating characteristic (ROC) curve (AUC) for TBIL was 0.736 (95% confidence interval (CI): 0.614–0.858, P=0.001), in which the optimal cut-off value was 64.5 μmol/L. The combined index named “TBIL” and “TBA” showed an AUC of 0.745 (0.626–0.865) for predicting the prognosis in patients with SALI. In addition, the Kaplan–Meier curve indicated that the 28-day survival rate was significantly lower in patients with higher serum TBIL levels (≥64.5 μmol/L) or higher value of TBIL and TBA (≥−0.8902). Conclusions. Elevated serum TBIL level is associated with poor outcomes in pediatric SALI. |
| format | Article |
| id | doaj-art-3c6c60bdcb8a4208b0bd33ac9adb48e9 |
| institution | Kabale University |
| issn | 1712-9532 1918-1493 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-3c6c60bdcb8a4208b0bd33ac9adb48e92025-02-03T01:26:36ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95321918-14932018-01-01201810.1155/2018/45917294591729Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver InjuryYun Cui0Yijun Shan1Rongxin Chen2Chunxia Wang3Yucai Zhang4Department of Critical Care Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200040, ChinaDepartment of Critical Care Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200040, ChinaDepartment of Critical Care Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200040, ChinaDepartment of Critical Care Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200040, ChinaDepartment of Critical Care Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200040, ChinaAims. The aim of this study was to assess the prognostic value of the serum total bilirubin (TBIL) level in pediatric patients with sepsis-associated liver injury (SALI). Methods. We performed a retrospective study of patients with SALI admitted to the pediatric intensive care unit (PICU) in Shanghai Children’s Hospital between December 2012 and December 2015. Serum TBIL concentration was determined within 72 h after PICU admission. Results. Seventy-two patients with SALI were included in this study. The overall mortality rate was 36.1% (26/72). The serum levels of TBIL of patients were significantly higher in the nonsurvivor group than the survivor group. Cox regression analysis indicated that the elevated serum TBIL level within 72 hours after admission was an independent risk factor of mortality in patients with SALI. Furthermore, the area under the receiver-operating characteristic (ROC) curve (AUC) for TBIL was 0.736 (95% confidence interval (CI): 0.614–0.858, P=0.001), in which the optimal cut-off value was 64.5 μmol/L. The combined index named “TBIL” and “TBA” showed an AUC of 0.745 (0.626–0.865) for predicting the prognosis in patients with SALI. In addition, the Kaplan–Meier curve indicated that the 28-day survival rate was significantly lower in patients with higher serum TBIL levels (≥64.5 μmol/L) or higher value of TBIL and TBA (≥−0.8902). Conclusions. Elevated serum TBIL level is associated with poor outcomes in pediatric SALI.http://dx.doi.org/10.1155/2018/4591729 |
| spellingShingle | Yun Cui Yijun Shan Rongxin Chen Chunxia Wang Yucai Zhang Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury |
| title_full | Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury |
| title_fullStr | Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury |
| title_full_unstemmed | Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury |
| title_short | Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury |
| title_sort | elevated serum total bilirubin level is associated with poor outcomes in pediatric patients with sepsis associated liver injury |
| url | http://dx.doi.org/10.1155/2018/4591729 |
| work_keys_str_mv | AT yuncui elevatedserumtotalbilirubinlevelisassociatedwithpooroutcomesinpediatricpatientswithsepsisassociatedliverinjury AT yijunshan elevatedserumtotalbilirubinlevelisassociatedwithpooroutcomesinpediatricpatientswithsepsisassociatedliverinjury AT rongxinchen elevatedserumtotalbilirubinlevelisassociatedwithpooroutcomesinpediatricpatientswithsepsisassociatedliverinjury AT chunxiawang elevatedserumtotalbilirubinlevelisassociatedwithpooroutcomesinpediatricpatientswithsepsisassociatedliverinjury AT yucaizhang elevatedserumtotalbilirubinlevelisassociatedwithpooroutcomesinpediatricpatientswithsepsisassociatedliverinjury |