Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Zubieta-rodríguez R, Gómez-correa J, Rodríguez-amaya R, Ariza-mejia K, Toloza-cuta N. Hospital mortality in cirrhotic patients at a tertiary care center. Revista de Gastroenterología de México (English Edition) 2017;82:203-209. [DOI: 10.1016/j.rgmxen.2016.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open

For:	Zubieta-rodríguez R, Gómez-correa J, Rodríguez-amaya R, Ariza-mejia K, Toloza-cuta N. Hospital mortality in cirrhotic patients at a tertiary care center. Revista de Gastroenterología de México (English Edition) 2017;82:203-209. [DOI: 10.1016/j.rgmxen.2016.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open

Number

Cited by Other Article(s)

Vélez JL, Pérez A, Blanco JD, Berrouet MC, Valencia L, Soto S, Ramírez AS, Martínez V, Gallego JL, Jaillier J. Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023;43:9-20. [PMID: 38207155 PMCID: PMC10901446 DOI: 10.7705/biomedica.6963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/11/2023] [Indexed: 01/13/2024]

Abstract

INTRODUCTION

Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care.

OBJECTIVE

To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medellín, Colombia.

MATERIALS AND METHODS

This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics.

RESULTS

In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (± 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%). The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%). During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%.

CONCLUSION

Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate.

Collapse

Nartey YA, Antwi SO, Bockarie AS, Hiebert L, Njuguna H, Ward JW, Awuku YA, Plymoth A, Roberts LR. Mortality burden due to liver cirrhosis and hepatocellular carcinoma in Ghana; prevalence of risk factors and predictors of poor in-hospital survival. PLoS One 2022;17:e0274544. [PMID: 36099308 PMCID: PMC9469955 DOI: 10.1371/journal.pone.0274544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/28/2022] [Indexed: 11/19/2022] Open

Abstract

Liver-related diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), are significant causes of mortality globally. Specific causes and predictors of liver-related mortality in low resource settings require assessment to help inform clinical decision making and develop strategies for improved survival. The objectives of this study were to determine the proportion of liver-related deaths associated with liver cirrhosis, HCC, and their known risk factors, and secondly to determine predictors of in-hospital mortality among cirrhosis and HCC patients in Ghana. We first performed a cross-sectional review of death register entries from 11 referral hospitals in Ghana to determine the proportion of liver-related deaths and the proportion of risk factors associated with these deaths. Secondly, we conducted a retrospective cohort review of 172 in-patient liver cirrhosis and HCC cases admitted to a tertiary referral centre and determined predictors of in-hospital mortality using binary logistic regression and Kaplan-Meier survival analysis. In total, 8.8% of deaths in Ghanaian adults were due to liver-related causes. The proportion of liver-related deaths attributed to HBV infection was 48.8% (95% CI: 45.95-51.76), HCV infection was 7.0% (95% CI: 5.58-8.45), HBV-HCV co-infection 0.5% (95% CI: 0.1-0.9) and alcohol was 10.0% (95% CI: 8.30-11.67). Of 172 cases of HCC and liver cirrhosis, the in-patient mortality rate was 54.1%. Predictors of in-patient mortality in cirrhotic patients were increasing WBC (OR = 1.14 95% CI: 1.00-1.30) and the revised model for end-stage liver disease with sodium (MELD-Na) score (OR = 1.24 95% CI: 1.01-1.54). For HCC patients, female sex (OR = 3.74 95% CI: 1.09-12.81) and hepatic encephalopathy (grade 1) were associated with higher mortality (OR = 5.66 95% CI: 1.10-29.2). In conclusion, HBV is linked to a high proportion of HCC-related deaths in Ghana, with high in-hospital mortality rates that require targeted policies to improve survival.

Collapse

Chang YC, Fang YT, Chen HC, Lin CY, Chang YP, Tsai YH, Chen YM, Huang KT, Chang HC, Wang CC, Lin MC, Fang WF. The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis. J Clin Med 2022;11:jcm11061629. [PMID: 35329955 PMCID: PMC8951259 DOI: 10.3390/jcm11061629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023] Open

Abstract

Background: We aimed to determine whether septic patients with liver cirrhosis (LC) had worse survival than septic patients without liver cirrhosis (WLC). We also investigated the survival of septic patients with compensated liver cirrhosis (CLC) and decompensated liver cirrhosis (DLC). Methods: This study enrolled 776 consecutive adult patients with sepsis admitted to the medical intensive care units of a tertiary referral hospital. Clinical factors and laboratory data were collected for analysis. Propensity scoring was also used for the control of selection bias. The variables included in the propensity model were age, sex, presence of diabetes mellitus, hypertension, cardiovascular accident, chronic kidney disease, malignancy, APCHE II (Acute Physiology and Chronic Health Evaluation) score, hemoglobin, and platelet data on the day when sepsis was confirmed. Seven-day, ICU, and hospital mortality were analyzed after correcting for these confounding factors. Results: Of the 776 septic patients, 64 (8.2%) septic patients presented with LC. Patients were divided into two groups—LC (n = 64) and WLC (n = 712)—which presented different rates of hospital mortality (LC: 62.5% vs. WLC: 41.0%, p = 0.001). We further separated septic patients with LC into two groups: patients with CLC (n = 24) and those with DLC (n = 40). After propensity score matching, the survival of septic patients with CLC (63.6%) was not inferior to patients WLC (54.5%) (p = 0.411). Patients with DLC had more hospital mortality, even after matching (p < 0.05). The Quick SOFA (qSOFA) score, SOFA score, and sub-SOFA score were also comparable between groups. SOFA scores were not significantly different between the CLC and WLC groups after matching. Poor SOFA scores were observed in the DLC group on days 3 and 7 after matching (p < 0.05). Conclusions: Septic patients with LC had higher mortality compared to patients WLC before matching. However, after propensity score matching, the survival of septic patients with CLC was non-inferior to patients WLC.

Collapse

Affiliation(s)

Ya-Chun Chang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.) Department of Internal Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung 802, Taiwan
Ying-Tang Fang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Hung-Cheng Chen Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Chiung-Yu Lin Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Yu-Ping Chang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Yi-Hsuan Tsai Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Yu-Mu Chen Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Kuo-Tung Huang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Huang-Chih Chang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.)
Chin-Chou Wang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.) Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
Meng-Chih Lin Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.) Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Wen-Feng Fang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-C.C.); (Y.-T.F.); (H.-C.C.); (C.-Y.L.); (Y.-P.C.); (Y.-H.T.); (Y.-M.C.); (K.-T.H.); (H.-C.C.); (C.-C.W.); (M.-C.L.) Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 613, Taiwan Correspondence: ; Tel.: +886-7-7317123 (ext. 8199)

Collapse