Influence of Fatty Liver and Cirrhosis on Survival in Septic Shock

Abstract

Purpose: Fatty Liver is increasingly common among healthy patients than previously thought. Its effect on sepsis is unknown. It is known that Cirrhosis and low albumin have increased mortality in sepsis. We wanted to study the effect of fatty liver on survival in patients with septic shock. Methods: Patients were selected based on those who were admitted to Cooper University Hospital ICU in septic shock over a three year period from 1/2008-1/2011. A total number of 293 patients were evaluated and separated based on mortality. Variables were collected and analyzed thought to play a role in mortality in septic shock such as lactate, CKD, cirrhosis, Albumin and Fatty Liver. Univariate analysis was used to compare the two groups (alive or deceased) for any significant differences (Table 1). Subsequently, each of the variables found to be significantly different [p<0.05] were then analyzed using multivariate analysis, to evaluate whether any were independent predictors of mortality in patients with septic shock (Table 2).Table 1: . No Caption available.Table 2: . No Caption available.Results: Using univariate analysis, those alive or deceased were compared looking at the number and percent of people with Fatty liver. 11.8% had fatty liver out of the alive group vs 8.4% in the deceased group, but the difference was not significant [p=0.39]. Variables found to be statistically significant were in patients with chronic kidney disease (CKD) [p= 0.05], having Multiple Organ Dysfunction (MOD) >2 [p=0.03] and patients with median Lactate within 24 hours [p=0.05]. Age, APACHE II, and cirrhosis were also found to be significant. These significant variables were then evaluated using multivariate analysis. When looking at differences in mortality, only Age [p=0.00], APACHE II [p=0.00] and presence of cirrhosis [p=0.03] were found to be independent predictors of mortality in Septic shock patients. Conclusion: Based on the collected data, it appears that presence of fatty liver does not have any significant effect on mortality in septic shock. Variables that were found to be significant independent predictors in relation to mortality in septic shock were mean age, mean APACHE II score, and presence of Cirrhosis all of which had previously been illustrated in prior studies.