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Incidence, characteristic and risk factors of drug-induced liver injury in hospitalized patients: a matched case-control study
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  • Xianghao Kong,
  • Daihong Guo,
  • Siyuan Liu,
  • Yu Zhu,
  • Chengxuan Yu
Xianghao Kong
Chinese PLA General Hospital
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Daihong Guo
Chinese PLA General Hospital
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Siyuan Liu
Chinese PLA General Hospital
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Yu Zhu
Chinese PLA General Hospital
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Chengxuan Yu
Chinese PLA General Hospital
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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.

Peer review status:ACCEPTED

06 Jan 2021Submitted to British Journal of Clinical Pharmacology
11 Jan 2021Submission Checks Completed
11 Jan 2021Assigned to Editor
12 Jan 2021Reviewer(s) Assigned
08 Feb 2021Review(s) Completed, Editorial Evaluation Pending
10 Feb 2021Editorial Decision: Revise Major
21 Mar 20211st Revision Received
22 Mar 2021Submission Checks Completed
22 Mar 2021Assigned to Editor
22 Mar 2021Review(s) Completed, Editorial Evaluation Pending
23 Mar 2021Editorial Decision: Revise Minor
24 Mar 20212nd Revision Received
24 Mar 2021Submission Checks Completed
24 Mar 2021Assigned to Editor
24 Mar 2021Review(s) Completed, Editorial Evaluation Pending
25 Mar 2021Editorial Decision: Accept