The occurrence and risk factors of ischemic hepatitis in adult patients after cardiac surgery received extracorporeal membrane oxygenation support
Fu Hongfu
Wang Yan
Wang Liangshan
Xin Meng
Xie Haixiu
Tian Xiaqiu
Hao Xing
Wang Hong
Hou Xiaotong
Abstract：Objective To investigate the incidence,prognosis,and risk factors for ischemic hepatitis(IH)in adult patients received veno-arterial extracorporeal membrane oxygenation(V-A ECMO)assistance after cardiac surgery.Methods A retrospective analysis was conducted on adult patients receiving V-A ECMO support after cardiac surgery at Beijing Anzhen Hospital from January 2018 to November 2023.Patients were divided into the IH group and the control group(CG)according to the occurrence of IH.Survival analysis was used to assess the impact of IH on patient prognosis.LASSO regression was employed to screen for variables related to IH occurrence.Logistic regression was used to identify independent risk factors.Results A total of 328 patients were included,among whom 104(31.7%)developed IH.Mortality was significantly higher in the IH group compared to the CG(75.0%vs.44.2%,P<0.001).Preoperative hemoglobin(OR=0.99,95%CI:0.98-1.00,P=0.046),aortic cross-clamp time(OR=1.00,95%CI:1.00-1.01,P=0.025),lactate level(OR=1.14,95%CI:1.08-1.20,P<0.001)and sequential organ failure assessment(SOFA)score(OR=1.23,95%CI:1.06-1.43,P=0.005)prior to ECMO initiation were identified as risk factors for the occurrence of IH.Conclusion IH is an underrecognized condition in patients receiving V-A ECMO support after cardiac surgery and is strongly associated with poor prognosis.Preoperative hemoglobin,aortic cross-clamp time,lactate level and SOFA score prior to ECMO initiation are independent risk factors for IH.
Keywords：Ischemic hepatitisExtracorporeal membrane oxygenationPostcardiac surgery
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 23-28,35 )