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Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis

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Liver Research 2021年第1期5卷 28-32页

作者： Simcha Weissman Saad Saleem sachit sharma Menashe Krupka Faisal Inayat Muhammad Aziz James H.Tabibian Department of Medicine Hackensack Meridian Health Palisades Medical CenterNorth BergenNJUSA Department of Medicine Sunrise Hospital and Medical CenterLas VegasNVUSA Department of Medicine University of Toledo Medical CenterToledoOHUSA Department of Medicine Westchester Medical CenterValhallaNYUSA Department of Medicine Allama Iqbal Medical CollegeLahorePakistan Division of Gastroenterology and Hepatology University of Toledo Medical CenterToledoOHUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA David Geffen School of Medicine at UCLA Los AngelesCAUSA

Background and aims Anti-neoplastic immunotherapy has revolutionized cancer management;however,its safety profile with respect to liver-related injury remains largely ***,we analyzed a United States national database to determine the incidence,mortality,and predictors of hepatotoxicity in the setting of anti-neoplastic *** This was a nationwide retrospective study of hospital encounters from 2011 to 2014 using the National Inpatient Sample(NIS)*** utilized the International Classification of Diseases,Ninth Revision(ICD-9)coding system to identify all adult patients who underwent anti-neoplastic immunotherapy during *** primary outcome was the incidence of hepatotoxicity during the same *** outcomes included in-hospital mortality as well as socioeconomic and ethno-racial predictors of *** were performed using IBM SPSS Statistics *** The sample included 3002 patients who underwent inpatient anti-neoplastic *** incidence of hepatotoxicity was 10.1%,which was significantly higher as compared to a matched inpatient population(adjusted odds ratio(aOR)4.93,95%confidence interval(CI):3.80–6.40,P=0.001).No significant mortality difference was seen in those that developed hepatotoxicity compared to those who did not(aOR 0.47,95%CI:0.03–8.03,P=0.612).Age under 60(aOR 1.56,95%CI:1.23–1.78,P=0.050)and white race(aOR 1.85,95%CI:1.35–2.04,P<0.010)were independent risk factors for developing immunotherapy-associated *** In this large,nationwide database analysis,we found that anti-neoplastic immunotherapy was associated with a nearly five-fold risk of in-hospital hepatotoxicity as compared to a matched inpatient population,though without an associated mortality ***,younger age and white race were identified as predictors of immunotherapy-associated *** vigilance and prospective investigation of the

关键词： Hepatotoxicity Tumor immunotherapy Liver enzymes Outcomes Risk factors Mortality

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