Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort.

IF 2.6 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatic Medicine : Evidence and Research Pub Date : 2023-01-01 DOI:10.2147/HMER.S401628

Chantelli Iamblaudiot Razafindrazoto, Nitah Harivony Randriamifidy, Behoavy Mahafaly Ralaizanaka, Jean Tsitamita Andrianoelison, Haga Tsilavo Ravelomanantsoa, Mialitiana Rakotomaharo, Domoina Harivonjy Hasina Laingonirina, Sonny Maherison, Jolivet Auguste Rakotomalala, Anjaramalala Sitraka Rasolonjatovo, Andry Lalaina Rinà Rakotozafindrabe, Tovo Harimanana Rabenjanahary, Soloniaina Hélio Razafimahefa, Rado Manitrala Ramanampamonjy

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引用次数: 0

Abstract

Background: Cirrhosis is a pathology responsible for a significant hospital morbidity and mortality. The objective of this study was to determine the factors associated with hospital mortality in a sample of Malagasy cirrhotics.

Patients and methods: This was a retrospective cohort study from January 2018 to August 2020 conducted in the Hepato-Gastroenterology Unity, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar.

Results: One hundred and eight patients were included. The mean age was 51.13±13.50 years with a sex ratio of 2.37. The etiology of cirrhosis was dominated by alcohol (44.44%), hepatitis B virus (24.07%) and hepatitis C virus (13.89%). Twenty-eight patients (25.93%) had died. Factors associated with in-hospital mortality were hepatic encephalopathy (OR: 14.16; 95% CI: 5.08-39.4; p: 0.000), renal failure (OR: 8.55; 95% CI: 2.03-39.9; p: 0.0034), gastrointestinal bleeding (OR: 3.25; 95% CI: 1.32-7.92; p: 0.0099), hyponatraemia <130mmol/L (OR: 3.34; 95% CI: 1.04-10.6; p=0.046), Child-Pugh C classification (OR: 0.19; 95% CI: 0.12-0.21; p: 0.000), and MELD-Na score >32 (OR: 27.5; 95% CI: 4.32-174.8; p: 0.004).

Conclusion: The in-hospital mortality rate during acute decompensation of cirrhosis remains high in Madagascar. Hepatic encephalopathy, renal failure, GI bleeding and hyponatraemia are the main clinico-biological factors affecting in-hospital mortality. Early intervention on these modifiable factors is an important step to improve hospital outcomes. The natraemia, MELD score and MELD-Na score should be used in routine practice in Madagascar to identify patients with acute decompensation of cirrhosis at high risk of death.

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马达加斯加肝硬化急性失代偿患者住院死亡率相关因素:一项回顾性队列研究

背景:肝硬化是导致医院发病率和死亡率增高的一种病理。本研究的目的是确定与马达加斯加肝硬化患者住院死亡率相关的因素。患者和方法:这是一项回顾性队列研究，于2018年1月至2020年8月在马达加斯加塔那那利佛Joseph Raseta Befelatanana大学医院肝胃肠病学联合中心进行。结果:共纳入108例患者。平均年龄51.13±13.50岁，性别比2.37。肝硬化的病因以酒精(44.44%)、乙肝病毒(24.07%)和丙肝病毒(13.89%)为主。死亡28例(25.93%)。与住院死亡率相关的因素是肝性脑病(OR: 14.16;95% ci: 5.08-39.4;p: 0.000)，肾功能衰竭(OR: 8.55;95% ci: 2.03-39.9;p: 0.0034)，胃肠道出血(OR: 3.25;95% ci: 1.32-7.92;p: 0.0099)，低钠血症32 (OR: 27.5;95% ci: 4.32-174.8;p: 0.004)。结论:马达加斯加肝硬化急性失代偿期的住院死亡率仍然很高。肝性脑病、肾功能衰竭、消化道出血和低钠血症是影响住院死亡率的主要临床生物学因素。早期干预这些可改变的因素是改善医院结果的重要一步。钠血症、MELD评分和MELD- na评分应用于马达加斯加的常规实践，以识别死亡风险高的肝硬化急性失代偿患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatic Medicine : Evidence and Research GASTROENTEROLOGY & HEPATOLOGY-

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16 weeks

期刊介绍： Hepatic Medicine: Evidence and Research is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric hepatology in the clinic and laboratory including the following topics: Pathology, pathophysiology of hepatic disease Investigation and treatment of hepatic disease Pharmacology of drugs used for the treatment of hepatic disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered. As of 1st April 2019, Hepatic Medicine: Evidence and Research will no longer consider meta-analyses for publication.