BACKGROUND: Liver synthetic dysfunction predicts outcomes in cardiac intensive care unit (CICU) patients. OBJECTIVES: The purpose of this study was to evaluate the associations between the severity and extent of admission liver function test (LFT) abnormalities and mortality in a mixed CICU population. METHODS: This historical cohort study included unique CICU patients from 2007 to 2018 with available data for admission LFT values. We categorized each LFT from grade 0 to grade 4 based on multiples of the upper limit of normal. We evaluated in-hospital mortality using logistic regression and 1-year mortality using Cox proportional hazards regression. RESULTS: We included 7,284 patients, and 3,477 (47.7%) had at least 1 LFT with grade 1 or greater. In-hospital mortality was higher for patients with 1 or more abnormal LFTs (17.9% vs 6.4%
adjusted OR: 1.54 [95% CI: 1.27-1.86]
CONCLUSIONS: The severity and extent of LFT abnormalities are positively associated with in-hospital and 1-year mortality in CICU patients. Cardiohepatic syndrome is an important predictor of prognosis in CICU patients, and inclusion of LFTs in future risk-prediction tools could enhance prognostication.