Features and outcomes from a retrospective study of 570 hospitalized Chinese patients with drug-induced liver injury

Aims: To investigate the clinical features and outcomes of hospitalized patients with drug induced liver injury (DILI). Methods: The medical records of hospitalized patients with DILI from January 1997 through July 2016 were reviewed. Results: Five hundred seventy cases were reviewed, of which 381 (66.8%) were female. Four hundred fifty-eight cases (80.4%) presented with hepatocellular injury, 53 (9.3%) with cholestatic injury and 59 (10.4%) with mixed injury. Chronicity was more common in cholestatic and mixed injury cases than in hepatocellular cases (P<0.001). In the hepatocellular injury group, patients in the severity score >= 3 group were younger than the patients in the severity score <= 2 group (P=0.040). In the entire cohort, 487/570 (85.4%) patients resolved, 57/570 (10.0%) developed chronic liver injury, and 11/570 (1.9%) died. Thirty-two acute DILI patients with severity scores of 3 received steroid therapy, but no improvement was observed in the recovery time or resolution rate of these patients compared with that of the non-steroid group. Chinese herbal medicines were the most commonly used drugs, followed by antimicrobials, cardiovascular agents, endocrine agents, and nonsteroidal anti-inflammatory drugs (NSAIDs). Conclusions: Hepatocellular injury was the most common DILI pattern, and 10.0% of patients developed chronic DILI. Steroid therapy was not associated with an improved recovery time or survival in acute severe DILI patients. (C) 2017 Published by Elsevier Masson SAS.