Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis

Table 1 Baseline characteristics of the patients n (%)

Characteristics	Total (n = 412)	Severe hepatitis (n = 92)	Non-severe hepatitis (n = 320)	P value	Prolonged cholestasis(n = 21)	Non-prolonged cholestasis (n = 391)	P value
Age1 (yr)	34.4 ± 11.4	36.5 ± 11.5	33.8 ± 11.4	0.035	42.6 ± 15.0	34.0 ± 11.1	0.013
Gender, male	237 (57.5)	62 (67.4)	175 (54.7)	0.032	11 (52.4)	226 (57.8)	0.655
Etiology
Hepatitis A	319 (77.4)	67 (72.8)	252 (78.8)		8 (38.1)	311 (79.5)
Toxic	44 (10.7)	17 (18.5)	27 (8.4)		10 (47.6)	34 (8.7)
Unknown	25 (6.1)	1 (1.1)	24 (7.5)		0 (0)	25 (6.4)
Hepatitis B	16 (3.9)	4 (4.3)	12 (3.8)		2 (9.5)	14 (3.6)
Alcohol	4 (1.0)	1 (1.1)	3 (0.9)		0 (0)	4 (1.0)
Hepatitis C	2 (0.5)	1 (1.1)	1 (0.3)		1 (4.8)	1 (0.3)
Autoimmune	2 (0.5)	1 (1.1)	1 (0.3)		0 (0)	2 (0.5)
Etiology, toxic	44 (10.7)	17 (18.5)	27 (8.4)	0.001	10 (47.6)	34 (8.7)	< 0.001
ALT1 (IU/L)	2053 ± 1759	2145 ± 2207	2027 ± 1611	0.392	998 ± 1090	2110 ± 1772	0.001
ALP1 (IU/mL)	155 ± 75	152 ± 72	156 ± 76	0.983	153 ± 110	156 ± 73	0.265
Bilirubin1 (mg/dL)	5.6 ± 4.9	11.2 ± 6.7	3.9 ± 2.6	< 0.001	18.6 ± 6.9	4.9 ± 3.7	< 0.001
Albumin1 (g/dL)	3.9 ± 0.4	3.8 ± 0.4	4.0 ± 0.4	< 0.001	3.8 ± 0.4	3.9 ± 0.4	0.174
PT1 (%)	81.0 ± 18.0	75.2 ± 22.7	83.7 ± 16.6	0.003	84.6 ± 15.0	81.7 ± 18.6	0.721
GWT1, mm	5.2 ± 5.5	7.2 ± 6.0	5.5 ± 5.3	0.009	9.6 ± 6.7	5.7 ± 5.4	0.003
> 3	233 (56.5)	70 (70.7)	168 (51.7)	0.004	17 (81.0)	216 (55.2)	0.025
> 7	142 (34.5)	36 (39.1)	106 (33.1)	0.040	11 (52.4)	131 (33.5)	0.005
Arterial heterogeneity (+)	294 (80.1)	68 (73.9)	226 (70.6)	0.755	15 (71.5)	279 (71.3)	1.000
Periportal tracking (+)	348 (84.7)	78 (84.8)	270 (84.4)	0.869	18 (85.7)	330 (84.4)	1.000
LN number1	4.8 ± 3.0	5.1 ± 3.3	4.8 ± 2.9	0.581	5.3 ± 3.7	4.8 ± 3.0	0.701
LN size1 (cm)	0.97 ± 0.26	0.99 ± 0.28	0.96 ± 0.26	0.465	0.97 ± 0.30	0.97 ± 0.26	0.743
≥ 0.8	346 (84.5)	79 (85.9)	267 (83.4)	0.632	17 (81.0)	329 (84.1)	0.759
> 1	162 (39.3)	42 (45.7)	120 (37.5)	0.183	10 (47.6)	152 (38.9)	0.494
Ascites (+)	56 (13.6)	17 (18.5)	39 (12.2)	0.123	7 (33.3)	49 (12.5)	0.015
Spleen size1 (cm)	10.9 ± 1.6	11.04 ± 1.68	10.84 ± 1.60	0.419	10.44 ± 1.7	10.91 ± 1.6	0.094
≥ 12	95 (23.1)	24 (26.1)	71 (22.2)	0.483	3 (14.3)	92 (23.5)	0.431

¹Data presented as mean ± SD. ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; PT: Prothrombin time; GWT: Gallbladder wall thickness; LN: Lymph node.

Table 2 Relationship between computed tomography findings and liver chemistry (mean ± SD)

	GWT	LN maximum size	LN number	Spleen size	Arterial heterogeneity			Periportal tracking			Ascites
					Absence (n = 73)	Presence (n = 294)	P value	Absence (n = 63)	Presence (n = 348)	P value	Absence (n = 356)	Presence (n = 56)	P value
ALT(IU/L)	0.234 (< 0.001)	0.164 (0.001)	-0.013 (0.798)	0.119 (0.015)	1504 ± 1478	2216 ± 1794	< 0.001	1994 ± 2139	2064 ± 1688	0.074	1981 ± 1769	2509 ± 1641	0.005
ALP (IU/mL)	0.180 (< 0.001)	0.135 (0.006)	0.150 (0.003)	0.086 (0.082)	145 ± 76	159 ± 75	0.108	133 ± 63	159 ± 76	0.007	154 ± 76	164 ± 66	0.152
Bilirubin (mg/dL)	0.319 (< 0.001)	0.138 (0.005)	0.202   (< 0.001)	0.190 (< 0.001)	5.6 ± 5.2	5.6 ± 4.9	0.451	4.3 ± 5.1	5.8 ± 4.9	< 0.001	5.3 ± 4.7	7.0 ± 5.9	0.012
PT (s)	-0.118 (0.017)	-0.038 (0.445)	0.072   (0.149)	-0.092 (0.061)	86 ± 16	81 ± 18	0.032	81 ± 20	82 ± 18	0.795	82 ± 18	76 ± 17	0.006
Albumin (g/dL)	-0.282 (< 0.001)	-0.018 (0.717)	-0.017 (0.739)	-0.062 (0.206)	4.0 ± 0.4	3.9 ± 0.4	0.404	4.1 ± 0.4	3.9 ± 0.4	0.002	4.0 ± 0.4	3.7 ± 0.4	< 0.001

ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; PT: Prothrombin time; GWT: Gallbladder wall thickness; LN: Lymph node.

Table 3 Multivariate logistic regression analysis for the factors associated with severe acute hepatitis and prolonged cholestasis in acute hepatitis

Variables	OR	95%CI for OR		P value
		Lower	Upper
Severe acute hepatitis
Age (yr)	1.007	0.928	1.033	0.579
Gender, male	2.569	1.477	4.469	0.001
Etiology, toxic	3.531	1.444	8.635	0.006
Albumin (g/dL)	2.154	1.279	3.629	0.004
GWT (mm)	1.061	1.015	1.110	0.009
Prolonged cholestasis in acute hepatitis
Age (yr)	0.393	0.059	2.599	0.333
Etiology, toxic	6.848	0.960	48.859	0.055
ALT (IU/L)	1.000	1.000	1.001	0.607
Bilirubin (mg/dL)	1.628	1.331	1.991	< 0.001
GWT (mm)	1.172	1.024	1.342	0.021
Ascites	0.484	0.119	6.039	0.869

GWT: Gallbladder wall thickness; ALT: Alanine aminotransferase; OR: Odds ratio.