Early Liver Dysfunction within 48 Hours on Admission Aggravates Multiple Organ Dysfunction in Sepsis

Objective: Multiple organ dysfunction is the immediate cause for mortality of sepsis. To date, no clinical data exists about the impact of early liver injury on clinical outcome of sepsis. We investigated frequency, risk factors, and clinical effect of early liver dysfunction in sepsis. Design: One single center study. Patients: A total of 198 adult patients were included in consecutively 2 years from 2016 to 2018. Interventions: None. Measurements and Main Results: With approval from ethics committees of the Xiangya Hospital, we excluded patients with chronic liver diseases or under 18 years old. 198 patients were included according to published criteria. We found that early liver dysfunction occurred in 106 (53.5%) patients, younger septic patients were more prone to early liver damage (55.7±15.7 vs. 62.8±15.7, P<0.001). Patients with early liver dysfunction had significant higher SOFA and APACHE II scores, higher infectious indicators (PCT), higher lengths of vasopressor days, higher rates of CRRT, higher lactic acid, higher rate of shock and other organ failure (acute kidney injury, coagulation, myocardial injury). Hyperlipidemia patients had signicant higher rates of early liver dysfunction, AKI, CRRT. Logistical regression analysis demonstrated that hyperlipidemia and TBA were independent risk factors for early liver dysfunction in sepsis. Mortality in hospital (53 vs. 38), on day 180 (61 vs. 46), and after 1 year (63 vs. 50) was determined. Conclusion: Early liver dysfunction within 48 hours on admission aggravates multiple organ dysfunction in sepsis. Hyperlipidemia is independent risk factor of early liver dysfunction in sepsis. Early liver dysfunction and hyperlipidemia both exacerbate acute kidney injury and increase CRRT rate in sepsis. Funding Statement: The authors stated: None declared. Declaration of Interests: The authors stated: None declared. Ethics Approval Statement: Approval from ethics committees of the Xiangya Hospital and the Central South University of China.