Predicting fatal outcomes after drug-induced liver injury

A team of American researchers has recently examined the association between co-morbidity burden and outcomes in patients with drug-induced liver injury, developing a multiple logistic regression model to calculate risk of death inside of six months. The model identified independent variables associated with suspected drug-induced injury and 6-month mortality in 306 patients (the discovery cohort), and was validated using information from 247 patients with suspected drug-induced issues (validation cohort). The Charlson comorbidity index was used to calculate medical comorbidity burden, with patients scoring >2 considered to have significant comorbidities. The six-month mortality rate was 4.5% in the validation cohort and 8.5% in the discovery cohort. For the discovery cohort, six-month mortality was independently associated with significant comorbidities (odds ratio [OR], 5.4; 95% CI 2.1 – 13.8), model for end-stage liver disease score (OR, 1.11; 95% CI, 1.04–1.17), and serum level of albumin at presentation (OR, 0.39; 95% CI, 0.2–0.76). The outcome of this study was the development and validation of a model for clinical use, based on comorbidity burden, model for end-stage liver disease score and serum level of albumin to predict 6-month mortality for patients with suspected drug induced liver injury. See the original paper here.