Clinical Trajectory and Predictors of Intensive Care Unit Mortality Among Nonalcoholic Fatty Liver Disease Patients: A Retrospective Case–Control Study

Janini, Eiad; Fteiha, Bashar; Ramlawi, Imran; Mahamid, Mahmud

doi:10.1016/j.jceh.2022.11.010

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…In a recently published case-control study involving 250 patients admitted to a general ICU, individuals with SLD exhibited higher ICU mortality rates (64% vs. 31%), a higher incidence of sepsis and septic shock, and increased requirements for critical care when compared to those without SLD [41]. ICU mortality was correlated with FIB-4 and NAFLD fibrosis scores in the SLD group [41]. Similarly, patients with SLD in our cohort more frequently developed AKI and required RRT and IMV.…”

Section: Discussionmentioning

confidence: 99%

Steatotic Liver Disease and Sepsis Outcomes—A Prospective Cohort Study (SepsisFAT)

Krznaric,

Papic,

Vrsaljko

et al. 2024

JCM

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Background: While it has been shown that steatotic liver disease (SLD) is associated with systemic changes in immune response, the impact of SLD on sepsis outcomes has not yet been established. The aim of this study was to investigate the association between SLD and sepsis severity and outcomes. Methods: A prospective observational study included consecutively hospitalized adult patients with community-acquired sepsis during a 16-month period. Results: Of the 378 included patients (49.5% male, median age of 69, IQR 57–78 years), 174 (46%) were diagnosed with SLD. Patients with SLD were older and more frequently fulfilled the criteria for metabolic syndrome. There were no differences in the source and etiology of sepsis between the groups. Patients with SLD exhibited a higher incidence of acute kidney injury (29.3% vs. 17.6%), the need for renal replacement therapy (16.1% vs. 8.8%), and more frequent use of invasive mechanical ventilation (29.3% vs. 18.1%). In-hospital mortality was significantly higher in the SLD group (18.39% vs. 9.8%). The multivariable analysis indicated that SLD was associated with mortality (HR 2.82, 95% CI 1.40–5.71) irrespective of the other elements within metabolic syndrome. Conclusions: SLD might be associated with higher sepsis in-hospital mortality, and more frequent development of acute kidney and respiratory insufficiency requiring more critical care support.

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Section: Discussionmentioning

confidence: 99%

Steatotic Liver Disease and Sepsis Outcomes—A Prospective Cohort Study (SepsisFAT)

Krznaric,

Papic,

Vrsaljko

et al. 2024

JCM

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“…It diminishes the financial burden and potential complications of tissue biopsies, but also can be performed sequentially defining disease evolution. This concept in a liver process has been validated for liver fibrosis, by correlating the grade of liver fibrosis with plasma liver enzymes in multiple clinical trials, i.e., Fib-4 [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. The MELD score (modeling for end-stage liver disease) predicts mortality at 90 days in patients listed for liver transplantation, and it is the standard for liver graft allocation in the US and abroad [ 28 , 29 , 30 ].…”

Section: Conceptmentioning

confidence: 99%

The Current Status of the Liver Liquid Biopsy in MASH Related HCC: Overview and Future Directions

Ugonabo,

Udoh,

Rajan

et al. 2023

Biomolecules

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Metabolic dysfunction-associated steatohepatitis (MASH) is one of the major risk factors for chronic liver disease and hepatocellular carcinoma (HCC). The incidence of MASH in Western countries continues to rise, driving HCC as the third cause of cancer-related death worldwide. HCC has become a major global health challenge, partly from the obesity epidemic promoting metabolic cellular disturbances but also from the paucity of biomarkers for its early detection. Over 50% of HCC cases are clinically present at a late stage, where curative measures are no longer beneficial. Currently, there is a paucity of both specific and sensitive biological markers for the early-stage detection of HCC. The search for biological markers in the diagnosis of early HCC in high-risk populations is intense. We described the potential role of surrogates for a liver biopsy in the screening and monitoring of patients at risk for nesting HCC.

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Inflammatory liver diseases and susceptibility to sepsis

2024

Clinical Science

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Patients with inflammatory liver diseases, particularly alcohol-associated liver disease and metabolic dysfunction-associated fatty liver disease (MAFLD), have higher incidence of infections and mortality rate due to sepsis. The current focus in the development of drugs for MAFLD is the resolution of non-alcoholic steatohepatitis and prevention of progression to cirrhosis. In patients with cirrhosis or alcoholic hepatitis, sepsis is a major cause of death. As the metabolic center and a key immune tissue, liver is the guardian, modifier, and target of sepsis. Septic patients with liver dysfunction have the highest mortality rate compared with other organ dysfunctions. In addition to maintaining metabolic homeostasis, the liver produces and secretes hepatokines and acute phase proteins (APPs) essential in tissue protection, immunomodulation, and coagulation. Inflammatory liver diseases cause profound metabolic disorder and impairment of energy metabolism, liver regeneration, and production/secretion of APPs and hepatokines. Herein, the author reviews the roles of (1) disorders in the metabolism of glucose, fatty acids, ketone bodies, and amino acids as well as the clearance of ammonia and lactate in the pathogenesis of inflammatory liver diseases and sepsis; (2) cytokines/chemokines in inflammatory liver diseases and sepsis; (3) APPs and hepatokines in the protection against tissue injury and infections; and (4) major nuclear receptors/signaling pathways underlying the metabolic disorders and tissue injuries as well as the major drug targets for inflammatory liver diseases and sepsis. Approaches that focus on the liver dysfunction and regeneration will not only treat inflammatory liver diseases but also prevent the development of severe infections and sepsis.

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Clinical Trajectory and Predictors of Intensive Care Unit Mortality Among Nonalcoholic Fatty Liver Disease Patients: A Retrospective Case–Control Study

Cited by 3 publications

References 38 publications

Steatotic Liver Disease and Sepsis Outcomes—A Prospective Cohort Study (SepsisFAT)

Steatotic Liver Disease and Sepsis Outcomes—A Prospective Cohort Study (SepsisFAT)

The Current Status of the Liver Liquid Biopsy in MASH Related HCC: Overview and Future Directions

Inflammatory liver diseases and susceptibility to sepsis

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