An investigation of early prognostic factor of sepsis-associated liver injury

We retrospectively investigated the clinical features of sepsis-associated liver injury in Teikyo University Mizonokuchi Hospital and examined which factors useful to predict prognosis in an early onset. In 116 patients with sepsis, 61 cases (52.6%) were diagnosed as sepsis-associated liver injury. Mortality rate was higher in patients having sepsis-associated liver injury. The concurrence of DIC was more frequent in the cases of sepsis-associated liver injury than in septic cases without liver injury. Interestingly, serum levels of FDP and D-dimer were higher in the cases of sepsis-associated liver injury even though without DIC. Ten cases including three cases of MRSA infection presented jaundice and died. As for the fatal cases, serum levels of ALP and γ-GTP were significantly higher than those of survivors. In a multivariate analysis, high ALP level was the only convaleacence prediction factor in the sepsis-associated liver injury. These results suggest that high serum levels of ALP and γ-GTP and detection of MRSA are useful to predict poor prognosis of sepsis-associated liver injury in an early stage.