2014, Number 1
Serum Levels of Gamma Glutamyl Transpeptidase as Prognostic Indicator of Intrahospitalary Mortality in Patients with Severe Alcoholic Hepatitis
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ABSTRACTBackground: Alcoholic hepatitis is one of the major health problems in Mexico, its mortality is 30%-60% in the severe form. The gamma glutamyl transpeptidase (GGT) is a sensitive parameter of liver disease induced by alcohol. The above data suggest that serum GGT can be an indicator of healthy liver tissue.
Objective: To determine whether there is an association between serum GGT with hospital mortality in patients with severe alcoholic hepatitis.
Material and method: An observational, analytic, cohort study included 48 patients in total with diagnosis of severe alcoholic hepatitis, 24 patients with higher than 300 U/L and 24 patients with lower than 300 U/L. Serum GGT and total bilirubin levels were measured at admission and at 28 days. Registering developing of hepatic encephalopathy, acute renal failure, infections, upper gastrointestinal bleeding and documenting the days of hospital stay (DHS) as well as number of deaths attributed to the alcoholic hepatitis presented in each group.
Results: The association of GGT with mortality in patients with severe alcoholic hepatitis using χ2 was 2,087 with a value of p = 0.149, RR was 0.643 with CI 95% from 0.135 to 1.365. For hepatic encephalopathy, χ2 was 4.463 with a p ‹0.05, the RR was 0.632 with CI 95% from 0.403 to 0.99. For acute renal failure the χ2 was 7.056 with a p ‹0.05, the RR was 0.357, with CI 95% in 0.153 to 0836. The χ2 for upper gastrointestinal bleeding was 2.009 with a p › 0.05 and a RR of 4.000, with 95% CI 0.482 to 33.22. The infectious processes resulted in a χ2 of 4,364, with a p ‹0.05. The treatment response obtained a χ2 of 0.99, with a p value = 0.32, with a RR of 0.587 with CI 95% in 0.203 to 1.693.
Conclusions: The elevated serum GGT was not associated to lower mortality in patients with severe alcoholic hepatitis; however, it showed to be a protective factor against complications such as hepatic encephalopathy, acute renal failure and infections, but not against upper gastrointestinal bleeding. There was no association between serum GGT levels and the number of days of hospital stay, response to treatment and bilirubin total levels at admission and 28 days after.
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