Clinical features and prognosis of drug-induced liver injury: An analysis of 95 cases

Objective To analyze and summarize the clinical data of drug-induced liver injury (DILI) , and to investigate the clinical features and prognosis of DILI. Methods A retrospective analysis was performed for the clinical data of 95 patients with DILI who were admitted to The First Affiliated Hospital of Xi'an Medical University from February 2010 to February 2016, including sex, age, medication history, underlying diseases, clinical manifestation, laboratory and imaging findings, treatment, and prognosis. A logistic regression analysis was used to investigate the influencing factors for prognosis. Results Respiratory system diseases ranked first among the underlying diseases treated by drugs that caused DILI and accounted for 25. 26% (24/95) , and of all patients, 23. 16% (22/95) had tuberculosis. Among the drugs that caused DILI, traditional Chinese medicine ranked first and accounted for 44. 21% (42/95) , followed by antitubercular agents which accounted for 22. 11% (21/95) . DILI often occurred within 15-30 days of medication. Poor appetite was the most common symptom of DILI, and jaundice was the most common positive sign. Elevated alanine aminotransferase was the most common laboratory result of DILI.Acute hepatocellular injury type was the most common type of DILI. Most DILI patients had good prognosis, and patients with response to treatment accounted for 95. 79% (91/95) , including those who were improved or cured. Age (odds ratio [OR]= 0. 054, 95% confidence interval (CI) : 0. 002-0. 076, P = 0. 037) , alkaline phosphatase (OR = 0. 004, 95% CI: 0. 001-0. 006, P = 0. 043) , total bilirubin (OR = 0. 028, 95% CI: 0. 001-0. 039, P = 0. 035) , and direct bilirubin (OR = 0. 008, 95% CI: 0. 001-0. 014, P = 0. 036) were independent risk factors for prognosis. Conclusion DILI does not have specific clinical manifestations and can easily be missed or misdiagnosed. Clinicians should use drugs rationally, monitor the presence of hepatotoxicity, and strengthen the public health education on safe medication.