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[Hyperbilirubinemia associated with sepsis in the elderly]
M Nishinaga1, T Fukazawa, K Fukami
1Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital.
Summary
Hyperbilirubinemia occurs in 5.8% of elderly sepsis patients, presenting with elevated total bilirubin disproportionate to other liver enzymes. Early recognition is crucial for effective treatment of febrile elderly patients.
Area of Science:
- Geriatric Medicine
- Hepatology
- Infectious Diseases
Context:
- Sepsis is a life-threatening condition.
- Elderly patients present unique challenges in sepsis management.
- Hyperbilirubinemia can be an indicator of sepsis severity.
Purpose:
- To determine the frequency of hyperbilirubinemia in elderly patients with sepsis.
- To describe the clinical and histological characteristics of sepsis-associated hyperbilirubinemia.
- To highlight the importance of recognizing hyperbilirubinemia in febrile elderly patients.
Summary:
- A retrospective analysis of 117 autopsy sepsis cases identified 4 cases (5.8%) with hyperbilirubinemia (average 4.1 mg/dl) attributed to sepsis itself.
- These cases showed disproportionately high total bilirubin levels compared to other liver function tests.
- Liver histology revealed mild, nonspecific findings like cholestasis and Kupffer cell hyperplasia.
Impact:
- This study underscores the significance of monitoring bilirubin levels in elderly sepsis patients.
- Recognizing sepsis-associated hyperbilirubinemia aids in timely and appropriate clinical management.
- Findings contribute to a better understanding of liver dysfunction during sepsis in the elderly.