Abstract
Objectives:The present study aimed to determine the effect of tracheobronchial aspiration on hospitalization outcomes and the factors influencing its occurrence.Methods:This prospective descriptive study was conducted from January 2017 to December 2020 at GMC/DHQ-Teaching Hospital in Gujranwala, Pakistan. All consenting liver cirrhosis patients with hepatic encephalopathy > 12 years of age admitted at the study site were included. The patient’s baseline characteristics and the hospitalization outcomes were noted in terms of death and discharge. The collected data was analyzed using SPSS version 22.0. The predictors of tracheobronchial aspiration were determined using Independent Sample T test and Chi-square test for quantitative and qualitative variables respectively. The p-values were taken statistically significant if < 0.05. A binary logistic regression analysis was performed to ascertain the effect of significant factors on the likelihood of tracheobronchial aspiration.Results:Among the total of 294 patients, 28.0% died during hospitalization. Death occurred significantly more in group of patients who had tracheobronchial aspiration (62.7% vs 12.0%, p<0.01). Increasing age was associated with increased chance of tracheobronchial aspiration (p<0.01). Male gender (49.6% vs 8.2%, p<0.01), patients whose hepatic encephalopathy was precipitated by upper GI bleed (59.7% vs 22.9%, p<0.01), and patients with comorbidities (p=0.02) were significantly prone to tracheobronchial aspiration.Conclusions:Tracheobronchial aspiration is a significant predictor of inpatient mortality among patients with hepatic encephalopathy. Male gender, increasing age & upper GI bleed predict aspiration in hepatic encephalopathy patients.
Highlights
Liver cirrhosis is suggested to be one of the significant public health concerns in Pakistan.[1]
Out of 294 patients with hepatic encephalopathy, 28% died during hospitalization, while tracheobronchial aspiration was observed among 31.9% (94 out of 294)
Among factors that influenced tracheobronchial aspiration, male gender was more prone to tracheobronchial aspiration. 49.6% male (64 out of 129) & only 18.2% female (30 out of 165) suffered tracheobronchial aspiration (p
Summary
Liver cirrhosis is suggested to be one of the significant public health concerns in Pakistan.[1]. The most common etiology of liver cirrhosis in Pakistan is hepatitis C virus (HCV) infections, with estimated prevalence, ranges from 4.5% to 9.5% globally.[2,3]. The exact prevalence of this disorder worldwide is still unknown.[4]. Cirrhosis is usually an advanced form of progressive hepatic fibrosis that mainly occurs due to distortion of the hepatic architecture and the regenerative nodule.[4,5]. Non-alcoholic fatty liver disease and alcohol consumption are suggested to be the most common cause of liver cirrhosis.[1]. Pak J Med Sci March - April 2022 (Part-II) Vol 38 No 4 www.pjms.org.pk 928 Cirrhosis is usually an advanced form of progressive hepatic fibrosis that mainly occurs due to distortion of the hepatic architecture and the regenerative nodule.[4,5] Chronic viral hepatitis, non-alcoholic fatty liver disease and alcohol consumption are suggested to be the most common cause of liver cirrhosis.[1]
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