Incidencia de la hipertransaminemia marcada en un departamento de salud de la Comunidad Valenciana (período 2002-2003)

Abstract

Marked hypertransaminasemia (HT) is not an infrequent situation within clinical practice, which is usually interpreted as primary acute liver damage. The objectives of this study were to determine the incidence, mortality rate and aetiology of marked HT among the general population, and the use therefore as an indicator of primary acute liver damage. A retrospective study was made of all patients with marked HT (ALT >400 IU/L) which were attended over a two-year period at the Healthcare Department n 11 in the Autonomous Community of Valencia. The computerized medical records and the results of the different supplementary examinations made were reviewed, and an analysis was made of different variables: clinical diagnosis and evolution, other liver function-related biochemical parameters and autoimmune and infection serology markers. A total of 414 patients with marked HT were identified (incidence of 88 cases/100,000 inhab./year), 73 of whom died (mortality rate of 16 deaths/100,000 inhab./year). Of the twenty aetiologies found, the most frequent were extrahepatic cholestasis (28.3%), hypoxic hepatopathy (14.6%) and sepsis (11.9%). The positive predictive value of marked HT as an indicator of primary acute liver damage was 27.7%. Marked HT is a disorder having a remarkable incidence rate among the general population, entailing a high mortality rate. Its aetiology is widely varied, being however the extrahepatic origin predominant.