Factors associated with death in patients with liver cirrhosis
Keywords:
Alcoholism, Child Pugh, Hepatorenal Syndrome, Liver Cirrhosis, Risk FactorsAbstract
Introduction: liver cirrhosis is a health problem in Cuba and in the world. There are multiple factors associated with mortality on admission or during hospitalization. Objectives: to determine the factors associated with death in patients with liver cirrhosis.
Method: an observational, analytic study of cases and controls was carried out. The cases were the deceased with the diagnosis of liver cirrhosis and the controls, the living patients discharged with this diagnosis. One control was matched for each case. The main variable was death from this entity and selected demographic and clinical variables were also considered. The data were tabulated and analyzed using the SPSS 20.0 statistical program. The statistical analysis included: distribution of absolute and relative frequencies of the variables and determination of risk (OR) with their respective 95% confidence interval.
Results There was a predominance of men 68,8% for cases and 72,7% in controls. The variables associated with death were: the decompensated Child Pugh classification (OR: 2.7 95% CI: 1,1 – 6,8; p = 0,037) and hepatorenal syndrome (OR: 3,4; 95% CI: 1,4 – 8,5; p = 0.008) Conclusions: the decompensated Child Pugh classification and hepatorenal syndrome behaved as risk factors for death in patients with liver cirrhosis. No variable behaved as a protective factor.
Conclusions: the variables that behaved as a risk factors for death were: Child Pugh classification and the hepatorenal syndrome.
References
GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. [Internet] 2015 [citado 11/11/2019]; 385:117-171.Disponible en: https://doi.org/10.1016/S0140-6736(14)61682-2
Torre-Delgadillo A. Complicaciones de la cirrosis: Encefalopatía, estado nutricional y ascitis. Departamento de Gastroenterología. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Rev Gastroent Mex. [Internet]. 2013 [citado 12/11/2019]; 78 (supl 1):103-105.Disponible en: https://doi.org/10.1016/j.rgmx.2013.07.001
Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2019. [Internet] La Habana, 2020 [citado 14/12/2019]. Disponible en: http://bvscuba.sld.cu/anuario-estadistico-de-cuba/
Fleming, KM; Aithal GP; Card TR; West, J. All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver Int. [Internet]. 2012 [citado 8/11/2019]; 32:7984. Disponible en: https://doi.org/10.1111/j.1478_3231.2011.02517.x
Nadim MK; Durand F; Kellum JA; Levitsky J; O`Leary JG; Karvellas CJ et al. Management of the critically ill patient with cirrhosis: a multidisciplinary perspective. J Hepatol. [Internet] 2016. [citado 13/11/2019]; 64(3): 717-735. Disponible en: https://doi.org/10.1016/j.jehep.2015.10.019
Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2019. [Internet] La Habana, 2020 [citado 14/12/2019]. Disponible en: https://files.sld.cu/bvscuba/files/2019/04/Anuario-Electrónico-Español-2018-ed-2019-compressed.pdf
Bhardwaj, A; Kedarisetty ,C; Vashishtha, C; Bhadoria, A; Jindal,A; Kumar,G et al. Carvedilol delays the progression of small esophageal varices in patients with cirrhosis: a randomized placebo-controlled trial. Gut. [Internet].2017. [citado 15/11/2019].66(10):1838-1843. Disponible en: http://doi.org/10.1136/gutjnl-2016-311735
Bernal,V;Bosch,J. Cirrosis Hepática. Libro de Gastroenterología y Hepatología. Problemas comunes en La práctica clínica.[Internet].2da ed.España: Jarpyo Editores,S.A.;2017.[citado 13/12/2019]:867-892.Disponible en: https://www.aegastro.es/sites/default/files/archivos/ayudas-practicas/60_Cirrosis_hepatica.pdf
Ramos, C; Castellanos, H; Martínez, C; Orlate, I; Martinez, A; Santoyo,A. Insuficiencia hepática crónica y hemostasia. Ver Colomb Gastroent.[Internet]. 2017. [citado 18/11/2019]. 32(4):349-357. Disponible en: http://doi.org/10.22516/25007440.178
Flores, J; Velarde, J; Díaz, P; Mercado, L; Alonzo, C; Marfil, B et al. Hiperlactemia y Mortalidad en pacientes com falla hepática aguda en crónico. RevMedMD.[Internet].2019.[citado 23/12/2019].10(2):76-83.Disponible en: http://www.medigraphic.com/pdf/revmed/md-2018/md182e.pdf
Garcia, G; Abraldes, J; Berzigotti, A; Bosch, J. Portal Hypertensivebleeding in Cirrhosis: Risk Stratification, Diagnosis, and management: 2016 practiceGuidance. American Association for theStudyofLiverDiseases. Hepatology. [Internet].2017. [citado 28/11/2019].65:310-335. Disponible en: http://doi.org/10.1002/hep.28906
Guevara, M; Arroyo, V. Ascitis y trastornos de La función renal del enfermo com cirrosis hepática. Libro de Gastroenterología y Hepatología. Problemas comunes em La práctica clínica. [Internet]. 2da ed. España: Jarpyo Editores, S.A.;2017. [citado 16/12/2019]:903-916. .Disponible en: https://www.aegastro.es/sites/default/files/archivos/ayudas-practicas/62_Ascitis_y_trastornos_de_la_funcion_renal_del_enfermo_con_cirrosis_hepatica.pdf
Buzzetti, E; Kalafateli, M; Thorburn, D; Davidson, B; Thiele, M; Lotte, L et al. Intervenciones farmacológicas para las hepatopatías alcohólicas (enfermedades hepáticas relacionadas con el consumo de alcohol). Cochrane. [Internet].2017. .[citado 11/12/2019] Vol 3. Disponible en: https://doi.org/10.1002/14651858.CD011646.pub2
Franchis,R. Expanding consensus in portal hypertension: report of theBaveno VI Consensus Workshop: stratifying Risk andindividualizing care for portal Hypertension. J Hepatol. [Internet].2015. [citado 8/11/2019]; 30: 1-10. Disponible en: https://dx.doi.org/10.1016/j.jhep.2015.05.022
Solana, J. Complicaciones de La cirrosis. Rev Gastroent Mex. [Internet]. 2012. [citado 15/1/2020]; 77 (supl 1): 92-93. Disponible en: http://dx.doi.org/10.1016/j.rgmx.2012.07.035
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