Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 8, 2017; 9(22): 959-966
Published online Aug 8, 2017. doi: 10.4254/wjh.v9.i22.959
Low serum albumin predicts early mortality in patients with severe hypoxic hepatitis
Pik-Eu Chang, Boon-Bee George Goh, Victoria Ekstrom, Ming-Liang Ong, Chee-Kiat Tan
Pik-Eu Chang, Boon-Bee George Goh, Victoria Ekstrom, Ming-Liang Ong, Chee-Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169856, Singapore
Pik-Eu Chang, Boon-Bee George Goh, Chee-Kiat Tan, Duke-NUS Medical School, Singapore 169857, Singapore
Author contributions: Chang PE and Tan CK designed the research; Chang PE and Goh BBG performed the research; Chang PE analyzed the data and wrote the paper; Goh BBG, Tan CK, Ekstrom V and Ong ML revised the paper; all authors have reviewed and approve of the final version of the paper.
Institutional review board statement: The study was approved by the ethics review board of Singapore General Hospital.
Informed consent statement: The ethics review board approved waiver of consent as the clinical data was anonymized prior to analysis and only aggregate data were reported.
Conflict-of-interest statement: None of the authors have any conflict of interests related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Chee-Kiat Tan, MBBS(NUS), MRCP(UK), FRCP(Edinburgh), Associate Professor, Department of Gastroenterology and Hepatology, Singapore General Hospital, Academia, 20 College Road, Level 3, Singapore 169856, Singapore.
Telephone: +65-62223322 Fax: +65-62273623
Received: January 18, 2017
Peer-review started: January 20, 2017
First decision: March 13, 2017
Revised: March 24, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: August 8, 2017
Core Tip

Core tip: Hypoxic hepatitis is an important cause of liver injury that is associated with a high mortality rate. We sought to evaluate the incidence, etiology and predictors of mortality of severe hypoxic hepatitis in a large tertiary-level hospital in Singapore. Our findings confirm that the prevalence and mortality rate of severe hypoxic hepatitis in Asians is consistent with previous studies. Importantly, the unique finding from our study is that low serum albumin level is an independent predictive factor for mortality in severe hypoxic hepatitis, with a five-fold increase in risk of death in patients with serum albumin less than 28 g/L.