A Southwest Nigerian tertiary hospital 5-year study of the pattern of liver disease admission

Abstract

Background: Liver disease is a major cause of morbidity and mortality globally. Its pattern varies with different geographical locations and these variations are determined by lifestyle, environmental, and genetic factors. This study determined the pattern, clinical presentations, risk factors, and determinants of morbidity and mortality in patients with liver disease admitted into a tertiary hospital in Ile-Ife, Nigeria, over a 5-year period; 2013–2017. Methods: Case records of patients admitted into the medical wards of Obafemi Awolowo University Teaching Hospital, Ile-Ife, with a diagnosis of liver disease were retrieved and information relating to demographics, risk factors, and types of liver disease as well as the results of relevant investigations, duration, and outcome of admission was extracted. Data were entered into SPSS version 20 and analyzed using frequencies and percentages which are presented in tabular form. Results: A total of 5,155 patients were admitted, liver diseases accounted for 324 (6.3%) of medical admissions within the period, with hepatocellular carcinoma (HCC) accounting for 52.8%, liver cirrhosis (LC) – 27.2%, acute hepatitis – 10.38%, metastatic liver disease – 4.1%, autoimmune hepatitis – 1.7%, DILI – 0.7%, liver abscess – 1%, abdominal tuberculosis – 1.4%, and unclassified etiology – 1.76%. A total of 139 cases were HBsAg positive, 64 took alcohol, 67 took herbs, while 57 took self-prescribed medications. Mortality among all patients admitted through the emergency compared with the medical clinic was 81.9% versus 18.1%. Elevated creatinine, coagulation disorder, hypoalbuminemia, and hypokalemia contributed to mortality. Conclusion: HCC and LC accounted for the majority of liver diseases in hospitalized patients with high mortality among all patients admitted through the emergency department and those with elevated creatinine, coagulopathy, and low potassium and albumin. Major etiologic factors were hepatitis B virus infection, alcohol, and self-prescribed medications.