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Prognostic value of biochemical liver parameters in neonatal sepsis‐associated cholestasis
Author(s) -
Oswari Hanifah,
Widjaja Ruth Karisma,
Rohsiswatmo Rinawati,
Cleghorn Geoffrey
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12053
Subject(s) - medicine , cholestasis , gastroenterology , aspartate transaminase , sepsis , alanine transaminase , odds ratio , transaminase , retrospective cohort study , neonatal cholestasis , bilirubin , multivariate analysis , liver transplantation , biliary atresia , alkaline phosphatase , biochemistry , chemistry , enzyme , transplantation
Aims The aim of the study was to evaluate the significance of total bilirubin, aspartate transaminase ( AST ), alanine transaminase and gamma‐glutamyltransferase ( GGT ) for predicting outcome in sepsis‐associated cholestasis. Methods A retrospective cohort review of the hospital records was performed in 181 neonates admitted to the N eonatal C are U nit. A comparison was performed between subjects with low and high liver values based on cut‐off values from ROC analysis. We defined poor prognosis to be when a subject had prolonged cholestasis of more than 3.5 months, developed severe sepsis, septic shock or had a fatal outcome. Results The majority of the subjects were male (56%), preterm (56%) and had early onset sepsis (73%). The poor prognosis group had lower initial values of GGT compared with the good prognosis group ( P = 0.003). Serum GGT (cut‐off value of 85.5 U / L ) and AST (cut‐off value of 51 U / L ) showed significant correlation with the outcome following multivariate analysis. The odds ratio ( OR ) of low GGT and high AST were OR 4.3 (95% CI :1.6 to11.8) and OR 2.9 (95% CI :1.1 to 8), respectively, for poor prognosis. In subjects with normal AST values, those with low GGT value had relative risk of 2.52 (95% CI :1.4 to 3.5) for poorer prognosis compared with those with normal or high GGT . Conclusion Serum GGT and AST values can be used to predict the prognosis of patients with sepsis‐associated cholestasis.