Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study

Background/Aims The effect of hyperammonemia on the mortality in patients with liver cirrhosis is well documented. However, little is known about the impact of hyperammonemia on mortality among intensive care unit patients without hepatic disease. We aimed to investigate factors associated with non-...

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Autores principales:	Jae Heon Kim, Hankyu Jeon, Sang Soo Lee, I Re Heo, Jung Woo Choi, Hee Jin Kim, Ra Ri Cha, Jae Min Lee, Hyun Jin Kim
Formato:	article
Lenguaje:	EN
Publicado:	The Korean Association of Internal Medicine 2021
Materias:	hyperammonemia non-hepatic disease intensive care units acute brain failure mortality Medicine R
Acceso en línea:	https://doaj.org/article/f73043eacfdb44eb9edb09b8e92bd683
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spelling	oai:doaj.org-article:f73043eacfdb44eb9edb09b8e92bd6832021-11-08T00:59:06ZImpact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study1226-33032005-664810.3904/kjim.2021.021https://doaj.org/article/f73043eacfdb44eb9edb09b8e92bd6832021-11-01T00:00:00Zhttp://www.kjim.org/upload/pdf/kjim-2021-021.pdfhttps://doaj.org/toc/1226-3303https://doaj.org/toc/2005-6648Background/Aims The effect of hyperammonemia on the mortality in patients with liver cirrhosis is well documented. However, little is known about the impact of hyperammonemia on mortality among intensive care unit patients without hepatic disease. We aimed to investigate factors associated with non-hepatic hyperammonemia among intensive care unit patients and to evaluate the factors related to the 7- and 90-day mortality. Methods Between February 2016 and February 2020, 948 patients without hepatic disease who had 972 episodes of admission to the intensive care unit were retrospectively enrolled and classified as hyperammonemia grades 0 (≤ 80 μg/dL; 585 [60.2%]), 1 (≤ 160 μg/dL; 291 [29.9%]), 2 (≤ 240 μg/dL; 55 [5.7%]), and 3 (> 240 μg/dL; 41 [4.2%]). Factors associated with hyperammonemia and the 7- and 90-day mortality were evaluated by multivariate logistic regression analysis and Cox regression analysis, respectively. Kaplan-Meier survival curves for the 7- and 90-day mortality were constructed. Results The independent risk factors for hyperammonemia were male sex (odds ratio, 1.517), age (0.984/year), acute brain failure (2.467), acute kidney injury (1.437), prothrombin time-international normalized ratio (2.272/unit), and albumin (0.694/g/dL). The 90-day mortality rate in the entire cohort was 24.3% and gradually increased with increasing hyperammonemia grade at admission (17.9%, 28.2%, 43.6%, and 61.0% in patients with grades 0, 1, 2, and 3, respectively). Additionally, non-hepatic hyperammonemia was an independent predictor of the 90-day mortality in intensive care unit patients. Conclusions Non-hepatic hyperammonemia is common (39.8%) and associated with the 90-day mortality among intensive care unit patients.Jae Heon KimHankyu JeonSang Soo LeeI Re HeoJung Woo ChoiHee Jin KimRa Ri ChaJae Min LeeHyun Jin KimThe Korean Association of Internal Medicinearticlehyperammonemianon-hepatic diseaseintensive care unitsacute brain failuremortalityMedicineRENThe Korean Journal of Internal Medicine, Vol 36, Iss 6, Pp 1347-1355 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hyperammonemia non-hepatic disease intensive care units acute brain failure mortality Medicine R
spellingShingle	hyperammonemia non-hepatic disease intensive care units acute brain failure mortality Medicine R Jae Heon Kim Hankyu Jeon Sang Soo Lee I Re Heo Jung Woo Choi Hee Jin Kim Ra Ri Cha Jae Min Lee Hyun Jin Kim Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
description	Background/Aims The effect of hyperammonemia on the mortality in patients with liver cirrhosis is well documented. However, little is known about the impact of hyperammonemia on mortality among intensive care unit patients without hepatic disease. We aimed to investigate factors associated with non-hepatic hyperammonemia among intensive care unit patients and to evaluate the factors related to the 7- and 90-day mortality. Methods Between February 2016 and February 2020, 948 patients without hepatic disease who had 972 episodes of admission to the intensive care unit were retrospectively enrolled and classified as hyperammonemia grades 0 (≤ 80 μg/dL; 585 [60.2%]), 1 (≤ 160 μg/dL; 291 [29.9%]), 2 (≤ 240 μg/dL; 55 [5.7%]), and 3 (> 240 μg/dL; 41 [4.2%]). Factors associated with hyperammonemia and the 7- and 90-day mortality were evaluated by multivariate logistic regression analysis and Cox regression analysis, respectively. Kaplan-Meier survival curves for the 7- and 90-day mortality were constructed. Results The independent risk factors for hyperammonemia were male sex (odds ratio, 1.517), age (0.984/year), acute brain failure (2.467), acute kidney injury (1.437), prothrombin time-international normalized ratio (2.272/unit), and albumin (0.694/g/dL). The 90-day mortality rate in the entire cohort was 24.3% and gradually increased with increasing hyperammonemia grade at admission (17.9%, 28.2%, 43.6%, and 61.0% in patients with grades 0, 1, 2, and 3, respectively). Additionally, non-hepatic hyperammonemia was an independent predictor of the 90-day mortality in intensive care unit patients. Conclusions Non-hepatic hyperammonemia is common (39.8%) and associated with the 90-day mortality among intensive care unit patients.
format	article
author	Jae Heon Kim Hankyu Jeon Sang Soo Lee I Re Heo Jung Woo Choi Hee Jin Kim Ra Ri Cha Jae Min Lee Hyun Jin Kim
author_facet	Jae Heon Kim Hankyu Jeon Sang Soo Lee I Re Heo Jung Woo Choi Hee Jin Kim Ra Ri Cha Jae Min Lee Hyun Jin Kim
author_sort	Jae Heon Kim
title	Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
title_short	Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
title_full	Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
title_fullStr	Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
title_full_unstemmed	Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
title_sort	impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study
publisher	The Korean Association of Internal Medicine
publishDate	2021
url	https://doaj.org/article/f73043eacfdb44eb9edb09b8e92bd683
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Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study

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