# Multiple Organ Failure as a Strong Predictor of Mortality in Patients with Hypoxic Hepatitis

## TL;DR

Multiple organ failure is a strong indicator of 30-day mortality in patients with hypoxic hepatitis, with higher organ failure grades significantly increasing the risk of death.

## Contribution

This study identifies multiple organ failure as a strong independent predictor of mortality in hypoxic hepatitis patients.

## Key findings

- MOF was present in nearly half of the patients with hypoxic hepatitis.
- Patients with MOF had a 70% 30-day mortality rate, compared to 17.9% for those without MOF.
- Each increase in MOF grade (number of failing organs) significantly raised the risk of mortality.

## Abstract

Background: Hypoxic hepatitis contributes to the development and progression of multiple organ failure (MOF). We evaluated whether MOF is associated with 30-day mortality in patients with hypoxic hepatitis. Methods: This retrospective study included 1011 patients diagnosed with hypoxic hepatitis at two centers in South Korea between 2010 and 2021. Organ failure was defined as a sequential organ failure assessment score ≥ 3 for each individual organ system. Results: Circulatory failure was the most common organ failure (n = 521), followed by respiratory (n = 380), cerebral (n = 307), renal (n = 236), coagulation (n = 182), and hepatic failure (n = 73). The proportions of patients without organ failure, with single organ failure, and with MOF were 28.7%, 22.3%, and 49.1%, respectively, with corresponding 30-day mortality rates of 17.9%, 29.3%, and 70.0%. In the multivariate Cox regression model, the presence of MOF grade 1 (two organ failures), grade 2 (three organ failures), and grade 3 (≥four organ failures) increased the risk of 30-day mortality by approximately threefold, fourfold, and fivefold, respectively, compared to patients without MOF. Conclusions: MOF is frequently observed in patients with hypoxic hepatitis and is a strong independent predictor of short-term mortality.