Drug-induced liver injury: clinical analysis of 139 elderly cases
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    Abstract:

    Objective To retrospectively investigate the clinical characteristics of drug-induced liver injury(DILI) in the elderly patients admitted to Chinese PLA 302nd hospital during 2003-2010. Methods DILI patients were divided into aged group (age>60 years, n=139) and non-aged group(age<60 years, n=105). Clinical features and biochemical indexes were compared between the two groups. Results Among 14 species causative agents which can induce DILI, the frequency ranging top five in aged group were Chinese herbal drugs(31.7%), antibiotics(13.7%), analgesics/antipyretics(12.2%), cardiovascular drugs(11.5%) and antitubercular drugs(6.5%), which were significantly different from non-aged group (Chinese herbal drugs: 43.8%, analgesics/antipyretics: 18.1%, antibiotics: 13.3%, antitubercular drugs: 6.7%, hyperthyroidism drugs: 4.8%). There were no statistical differences in incidence of jaundice and liver failure between aged and non-aged groups(77.1% vs 82.0% and 2.9% vs 4.8% ). However, the level of glutamyl transpeptidase and hospitalization time were higher and longer in aged group than in non-aged group. Liver injury types in aged group were cholestetic(45.9%), hepatocelluar(28.6%) and mixed(25.5%) DILD. In non-aged group, the percentage of above types was 39.3%, 34.8% and 25.8% respectively, with no significant difference with aged group. Conclusion Due to highly cholestetic icteric occurrence and sporadic liver failure of DILI in the elderly, it is necessary to prevent drug hepatotoxicity. We recommand to increase vigilance during pre-clinical drug option, especially for Chinese herbs, antibiotics and analgesics/antipyretics. Regular monitoring liver functions during administration is one of the effective preventive measures.

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