Abstract
BackgroundPatients with decompensated cirrhosis present with various complications and are associated with increased inpatients mortality. This study aimed to evaluate the complications and mortality in hospitalised patients with decompensated cirrhosis of liver.MethodsThis descriptive, cross-sectional, hospital-based study included 754 decompensated cirrhotic patients. The primary endpoints were mortality and hospital stay. The data analysis was done using Statistical Product and Service Solutions (SPSS) version 20 (IBM Corp., Armonk, NY). The chi-square test was used to compare the differences between different predictors of mortality with p<0.05 considered significant.ResultsA total of 754 patients (mean age 54±11.51 years; male/female ratio of 3.6:1) were studied. Ascites was the most common complication (99.2%) followed by upper gastrointestinal (UGI) bleed (42.3%), hepatic encephalopathy (32.5%), rebleeding (33.2%), spontaneous bacterial peritonitis (26%), and hepatorenal syndrome (19.1%). Inpatient mortality was 19.8%. The most common causes of mortality were rebleeding (21.5%) followed by hepatic encephalopathy (HE) (18.7%), hepatorenal syndrome (HRS) (14.7%), and spontaneous bacterial peritonitis (SBP) (12.1%). The presence of Grades IV HE, the presentation with shock, Child Turcotte Pugh (CTP) C, rebleeding, variceal bleed, HRS, hyponatremia (<130 mEq/L), the requirement of ≥3 units of blood and blood products, co-existence of hepatocellular carcinoma (HCC), and multiple comorbidities and complications in a single patient were strong predictors of mortality (p≤0.05).ConclusionsAscites followed by UGI bleed, hepatic encephalopathy, rebleeding, spontaneous bacterial peritonitis, and hepatorenal syndrome were common complications among the admitted decompensated cirrhotic patients. Inpatient mortality was high. The most common cause of mortality was rebleeding followed by hepatic encephalopathy, HRS, and SBP.
Highlights
Liver cirrhosis is a progressive chronic liver disease
Ascites was the most common complication (99.2%) followed by upper gastrointestinal (UGI) bleed (42.3%), hepatic encephalopathy (32.5%), rebleeding (33.2%), spontaneous bacterial peritonitis (26%), and hepatorenal syndrome (19.1%)
Ascites followed by UGI bleed, hepatic encephalopathy, rebleeding, spontaneous bacterial peritonitis, and hepatorenal syndrome were common complications among the admitted decompensated cirrhotic patients
Summary
Liver cirrhosis is a progressive chronic liver disease. The clinical presentation of cirrhosis varies with the aetiology. Clinical features of cirrhosis are secondary to portal hypertension and/or hepatocellular injury. Patients may present with severe liver injury without any obvious clinical signs [2]. Decompensated cirrhosis has either jaundice or varied complications like splenomegaly, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, development of esophagogastric varices, and variceal bleed [1]. Liver cirrhosis is an important health problem worldwide and is associated with increased morbidity and mortality. Patients with decompensated cirrhosis present with various complications and are associated with increased inpatients mortality. This study aimed to evaluate the complications and mortality in hospitalised patients with decompensated cirrhosis of liver
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