Outcomes of routine testing of liver enzymes in institutionalized geriatric patients.

E. N. Steinberg, H. M. Cho-Steinberg, Colin Howden

Research output: Contribution to journalArticle

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Abstract

This study sought to identify any benefit of routine liver function tests (LFTs) in chronically ill, geriatric patients and to assess which patients require evaluation for abnormal LFT levels. A retrospective chart review was carried out on 268 consecutive patients (M:F = 1.2, mean age 77 years, range 61-98 years) presenting for acute care from a long-term care facility. All were without jaundice, right upper quadrant pain, pruritus, bruising, or signs of chronic liver disease. The degree of LFT abnormality (aspartate aminotransferase, alanine aminotransferase, total bilirubin, or alkaline phosphatase) during admission was compared to the clinical diagnosis at the time of discharge. The most common diagnoses were pneumonia, urinary tract infection, and peripheral or coronary disease in 186 (60%). Thirty-seven patients (14%) had elevated LFT levels on admission. The levels normalized within 2 days in 26 of these patients, 25 of whom had a history of vascular disease (96%). Of the 11 remaining patients, 4 had coexistent vascular disease (36%), and 5 had LFT levels twice normal (none with vascular disease) and underwent abdominal ultrasound. One patient had a common bile duct stone successfully extracted. Enzyme abnormalities were due to hepatitis B or medication use in 10 of 11 patients. No patient had liver biopsy. All but one of the 268 patients were discharged without further evaluation. Over one year of follow up, no patient returned for a liver-related problem. Based on these findings, only those patients with LFT levels that are twice normal and which do not normalize within 2 days warrant further evaluation. Transient LFT abnormalities may be due to decreased liver perfusion.

Original languageEnglish (US)
Pages (from-to)267-270
Number of pages4
JournalThe American journal of managed care
Volume3
Issue number2
StatePublished - Jan 1 1997
Externally publishedYes

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geriatrics
Geriatrics
Liver Function Tests
Liver
Enzymes
Disease
Vascular Diseases
evaluation
chronically ill
Chronic Disease
contagious disease
pain
medication
Common Bile Duct
Long-Term Care
Pruritus
Aspartate Aminotransferases
Jaundice
Hepatitis B
Alanine Transaminase

All Science Journal Classification (ASJC) codes

  • Health Policy

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Outcomes of routine testing of liver enzymes in institutionalized geriatric patients. / Steinberg, E. N.; Cho-Steinberg, H. M.; Howden, Colin.

In: The American journal of managed care, Vol. 3, No. 2, 01.01.1997, p. 267-270.

Research output: Contribution to journalArticle

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