Effects of cholestasis and hypoxic hepatitis on prognosis of ICU patients: a retrospective study based on MIMIC Ⅲ database / 南方医科大学学报

OBJECTIVE@#Abnormalities of liver-related indices are common in ICU patients, but the effects of cholestasis and hypoxic hepatitis in critically ill patients remains unclarified. The purpose of this study was to investigate the effects of cholestasis and hypoxic liver dysfunction on the prognosis of ICU patients.@*METHODS@#A retrospective study was conducted based on the data of patients admitted to the ICU for the first time between 2001 and 2011 archived in the MIMIC-Ⅲ database. The patients were divided into cholestasis, hypoxic hepatitis and control groups, and their 28-day case fatality rate as the primary outcome was compared among the groups.@*RESULTS@#A total of 5852 ICU patients were included in the analysis. The incidence of cholestasis and hypoxic liver dysfunction was 31.9% (1869/5852) and 17.9% (1046/5852), respectively. There was no significant difference in 28-day case fatality rate between cholestasis group and the control group. Compared with the control group, the patients with hypoxic hepatitis had a significantly higher 28-day case fatality rate (46% 35%, < 0.01), a higher hospital case fatality rate (40% 31%, < 0.01), and a higher ICU case fatality rate (35.7% 22.2%, < 0.01). Logistic regression analysis showed that lactic acid (LAC), aspartate transaminase (AST), and international standard ratio (INR) were independent risk factors for 28-day case fatality rate.@*CONCLUSIONS@#The incidence of cholestatic liver dysfunction is higher than that of hypoxic hepatitis, but it does not increase the 28-day case fatality rate of the ICU patients, suggesting that cholestatic liver dysfunction may be the early adaptation of the liver to critical diseases.

Self-evaluation of sleep quality among students of a medical university / 第二军医大学学报

Objective To investigate the sleep quality of students from a medical university and to analyze the risk factors of sleep disorders. Methods Students from a medical university were selected with cluster sampling method. A total of 886 students were included in this study: there were 55 Major A students, 80 Major B students, 97 Major C students, 577 Major D students, and 77 Major E students. The students were investigated by Pittsburgh sleep quality index (PSQI) and sel-designed physical state questionnaire. Results (1)The number of effective questionnaire was 843 and sleep disorders were found in 284 students, with an incidence of 33. 7% and a PSQI score of 5. 48 + 0. 12. The incidences of sleep orders and PSQI scores were 43. 4% (23/53) and 6. 23 + 0. 48 for Major A, 32. 9% (23/70) and 4. 93 + 0. 44 for Major B, 40. 4% (36/89) and 5. 75 + 0. 34 for Major C, 32. 4% (183/564) and 5. 47 + 0. 14 for Major D and 28. 4% (19/67) and 5. 18 + 0. 40 for Major E, with no significant difference found for different majors (P>0. 05). (2)The factors leading to somnipathy included emotional stress, ambient noise, somatic pain, school learning, seldom late-night snack and occasional late-night snack (OR=0. 577, 0. 611, 0. 265, 0. 260, 0. 547, and 0. 507, respectively). Conclusion The students in the involved medical university have a low sleep quality which may affect their physical state during day time. Active measures should be taken to improve students sleep quality so as to insure their study.