Incidence, characteristic and risk factors of drug-induced liver injury
in hospitalized patients: a matched case-control study
Abstract
Abstract: Aims: The diagnosis of drug-induced liver injury (DILI) is
relatively complex, involving a wide variety of drugs. The purpose of
this study is to use algorithms to quickly screen DILI patients, count
incidence rates and find risk factors. Methods: The Adverse Drug Events
Active Surveillance and Assessment System-2 was used to extract the data
of hospitalized patients in 2019 according to the set standards, then
the RUCAM was used to evaluate patients who meet the standards. A
retrospective case-control study was conducted according to suspected
drugs, length of hospital stay, height and weight matched controls, and
logistic regression was used to find risk factors. Results: Among the
156,570 hospitalized patients, 480 patients (499 cases) of DILI were
confirmed, and the incidence of DILI was 0.32%. Anti-infective agents,
antineoplastic agents, non-steroidal anti-inflammatory drugs (NASIDs)
were the major category of causative drugs causing DILI, and the highest
incidence of DILI caused by agent of voriconazole. The latency period
and hospital stay of patients with cholestasis was relatively long.
Patients with hyperlipidemia (AOR: 1.884), cardiovascular disease (AOR:
1.465), pre-existing liver disease (AOR: 1.827) and surgical history
(AOR: 1.312) were likely to be risk factors for DILI. Conclusions: The
incidence of DILI in hospitalized patients was uncommon (0.32%), and
its pathogenic drugs were widely distributed. LiverTox’s information
could assist in the diagnosis of DILI. The incidence of DILI in many
drugs was seriously underestimated. It is recommended to focus on
patients with hyperlipidemia, cardiovascular disease, pre-existing liver
disease, and surgical history.