In Hospital Mortality Related to Cirrhosis of Liver in a Tertiary Care Rural Hospital
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2014, Vol 2, Issue 2
Abstract
The objective of the study was to identify the causes of mortality among the hospitalsed patients with decompensated cirrhosis of liver and to evaluate for the biochemical and hematological parameters that are related to mortality during hospitalization. Total number of cases are 70 and number of controls are 70. Both cases and controls were compared and found to be age and sex matched. . The Mean age of cases is 46.33 years and the mean age of controls is 45.56 years. The Child-Pugh, MELD and MELD Na scores were computed for each patient on admission. Both cases and control groups contained predominantly male patients, 91.4% and 94.3% respectively. The most common cause of liver dysfunction was found to be alcohol related. The most common cause of admission was hepatic encephalopathy in both groups. The other reasons for admission are renal insufficiency, refractory ascites, upper gastrointestinal bleeding. While evaluating for Chlid status in both groups, 11.4 % of patients in both groups had Child’s A cirrhosis. 48.6% of cases had Child’s B cirrhosis while 52.9% of controls had Child’s B cirrhosis. 40.0% cases and 35.7% controls had Child’s C cirrhosis. The mean MELD and MELD-Na was significantly higher for the cases group compared to the control group i.e 24.47 & 18.4 for MELD and 29.10 & 23.54 for MELD-Na for the cases and controls respectively. The most common causes of death are due to cirrhosis related complications associated with decompensation like hepatic encephalopathy, hepato renal syndrome and upper gastrointestinal bleeding. A small number of patients died due to non cirrhosis related complications most commonly infections. Univariate analysis was performed on all variables. A p value less than 0.05 was considered statistically significant. This analysis revealed that increasing levels of MELD, MELD- Na, serum creatinine, INR, WBC, neutrophilia and duration of disease were significantly associated with increased risk of death. On multivariate forward stepwise logistic regression, an elevated WBC count (p=0.02, OR 1.2) and creatinine (p=0.003, OR 1.2) were the only factors significantly associated with death. In this study, in hospital mortality in cirrhosis is predominantly due to hepatic dysfunction. The most common cause of mortality in decompensated cirrhosis is due to hepatic encephalopathy, hepato renal syndrome and upper gastro intestinal bleeding. Patients who had died also exhibited higher MELD and MELD sodium value levels. Therefore, when patients are admitted with hepatic decompensation, clinical parameter like duration of disease, hematological parameters like leukocyte count and neutrophilia, biochemical parameters like creatinine, SGPT and INR can help predict short term or in hospital mortality along with MELD and MELD sodium. In this study, Child score did not help in predicting short term mortality in hospitalized patients.
Authors and Affiliations
Shelly C Paul, Sridhar K, Srinivas MG, Harsha M, Harish Kumar Y, Mahaboob V Shaik, Thankappan KR
Keywords
Related Articles
- EP ID EP374812
- DOI -
- Views 64
- Downloads 0
Nanogel as a Pharmaceutical Carrier – Review Article
Abstract: A nanoparticle which is composed of a hydrogel with a cross linked hydrophilic polymer network is known as “Nanogel”. The term ‘nanogels’ defined as the nanosized particles formed by physically or chemically cr...
Diagnostic Evaluation of Syncope By 24 hour Holter Monitoring
The aim & objective was diagnostic evaluation by Holter Monitroing of Patient with clinical diagnosis of syncope referred to Department of Cardiology at SAIMS & PG Institute, Indore. We evaluated a total of 360 pati...
Role of Ultrasound and Computed Tomography Scan in Diagnosis of Acute Pancreatitis and Its Complications
The study includes 50 patients of acute pancreatitis, of them all has underwent ultrasound and only 35 patients has undergone CT scan in whom it was indicated. Out of 50 patients 40 were male and 10 were females. Majorit...
Determination of Sexual Dimorphism in Bikaner city population in Rajasthan by Odontometric Study of Permanent Maxillary Canine
Abstract: Establishment of a person's individuality is important for legal as well as humanitarian purpose and gender determination is an essential step in identifying an individual. Dental, fingerprint and DNA compariso...
An Assessment of Risk Behaviors among the Adolescent Students in the District of Burdwan, West Bengal
Abstract: Adolescence is the time to build healthy behavior, attitude and lifestyle that contribute to current and future health. They are the most vulnerable group to the risky behavior. Serious health and safety issues...