scholarly journals Predictive scoring systems for in-hospital mortality due to acutely decompensated liver cirrhosis in Indonesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saut Horas H. Nababan ◽  
Arif Mansjoer ◽  
Achmad Fauzi ◽  
Rino A. Gani
Keyword(s):  
Liver Cirrhosis ◽  
Hospital Mortality ◽  
Total Bilirubin ◽  
Total Bilirubin Level ◽  
Scoring Systems ◽  
Decompensated Liver Cirrhosis ◽  
Factors Associated ◽  
Class B ◽  
Pugh Class

Abstract Background Acutely decompensated liver cirrhosis is associated with high medical costs and negatively affects productivity and quality of life. Data on factors associated with in-hospital mortality due to acutely decompensated liver cirrhosis in Indonesia are scarce. This study aims to identify predictors of in-hospital mortality and develop predictive scoring systems for clinical application in acutely decompensated liver cirrhosis patients. Methods This was a retrospective cohort study using a hospital database of acutely decompensated liver cirrhosis data at Cipto Mangunkusumo National General Hospital, Jakarta (2016–2019). Bivariate and multivariate logistic regression analyses were performed to identify the predictors of in-hospital mortality. Two scoring systems were developed based on the identified predictors. Results A total of 241 patients were analysed; patients were predominantly male (74.3%), had hepatitis B (38.6%), and had Child–Pugh class B or C cirrhosis (40% and 38%, respectively). Gastrointestinal bleeding was observed in 171 patients (70.9%), and 29 patients (12.03%) died during hospitalization. The independent predictors of in-hospital mortality were age (adjusted OR: 1.09 [1.03–1.14]; p = 0.001), bacterial infection (adjusted OR: 6.25 [2.31–16.92]; p < 0.001), total bilirubin level (adjusted OR: 3.01 [1.85–4.89]; p < 0.001) and creatinine level (adjusted OR: 2.70 [1.20–6.05]; p = 0.016). The logistic and additive scoring systems, which were developed based on the identified predictors, had AUROC values of 0.899 and 0.868, respectively. Conclusion The in-hospital mortality rate of acutely decompensated liver cirrhosis in Indonesia is high. We have developed two predictive scoring systems for in-hospital mortality in acutely decompensated liver cirrhosis patients.

scholarly journals Validation of a new prognostic model to predict short and medium-term survival in patients with liver cirrhosis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tomasz Dziodzio ◽  
Robert Öllinger ◽  
Wenzel Schöning ◽  
Antonia Rothkäppel ◽  
Radoslav Nikolov ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Risk Score ◽  
Meld Score ◽  
Medium Term ◽  
Term Survival ◽  
Risk Of Death ◽  
Class B ◽  
Pugh Class ◽  
End Stage

Abstract Background MELD score and MELD score derivates are used to objectify and grade the risk of liver-related death in patients with liver cirrhosis. We recently proposed a new predictive model that combines serum creatinine levels and maximum liver function capacity (LiMAx®), namely the CreLiMAx risk score. In this validation study we have aimed to reproduce its diagnostic accuracy in patients with end-stage liver disease. Methods Liver function of 113 patients with liver cirrhosis was prospectively investigated. Primary end-point of the study was liver-related death within 12 months of follow-up. Results Alcoholic liver disease was the main cause of liver disease (n = 51; 45%). Within 12 months of follow-up 11 patients (9.7%) underwent liver transplantation and 17 (15.1%) died (13 deaths were related to liver disease, two not). Measures of diagnostic accuracy were comparable for MELD, MELD-Na and the CreLiMAx risk score as to power in predicting short and medium-term mortality risk in the overall cohort: AUROCS for liver related risk of death were for MELD [6 months 0.89 (95% CI 0.80–0.98) p < 0.001; 12 months 0.89 (95% CI 0.81–0.96) p < 0.001]; MELD-Na [6 months 0.93 (95% CI 0.85–1.00) p < 0.001 and 12 months 0.89 (95% CI 0.80–0.98) p < 0.001]; CPS 6 months 0.91 (95% CI 0.85–0.97) p < 0.01 and 12 months 0.88 (95% CI 0.80–0.96) p < 0.001] and CreLiMAx score [6 months 0.80 (95% CI 0.67–0.96) p < 0.01 and 12 months 0.79 (95% CI 0.64–0.94) p = 0.001]. In a subgroup analysis of patients with Child-Pugh Class B cirrhosis, the CreLiMAx risk score remained the only parameter significantly differing in non-survivors and survivors. Furthermore, in these patients the proposed score had a good predictive performance. Conclusion The CreLiMAx risk score appears to be a competitive and valid tool for estimating not only short- but also medium-term survival of patients with end-stage liver disease. Particularly in patients with Child-Pugh Class B cirrhosis the new score showed a good ability to identify patients not at risk of death.

qSOFA score not predictive of in-hospital mortality in emergency patients with decompensated liver cirrhosis

2018 ◽  
Vol 114 (8) ◽  
pp. 724-732 ◽  
Author(s):  
M. Müller ◽  
J. C. Schefold ◽  
A. B. Leichtle ◽  
D. Srivastava ◽  
G. Lindner ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hospital Mortality ◽  
Decompensated Liver Cirrhosis ◽  
Emergency Patients ◽  
Qsofa Score

scholarly journals Correlation between Hepatic Vein Wave form Changes on Doppler Ultrasound and the Severity of Diseases in Cirrhotic Patients

2021 ◽  
Vol 22 (2) ◽  
pp. 100-106
Author(s):  
Tarana Yasmin ◽  
Sohely Sultana ◽  
Mahmuda Nusrat Ima ◽  
Md Quamrul Islam ◽  
Shyamal Kumar Roy ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Doppler Ultrasound ◽  
Hepatic Vein ◽  
Wave Form ◽  
Venous Blood Flow ◽  
Class A ◽  
Class B ◽  
Pugh Class ◽  
Cirrhotic Patients ◽  
Class C

Background: Cirrhosis is a common problem and is a leading cause of chronic liver disease. Early diagnosis with assessment of severity of diseases may help prevent the associated complications and patients’ sufferings. Now a days Hepatic venous Doppler can be a tool for diagnosis of cirrhosis and to assess correlation between waveform changes and severity of diseases. Objective: The purposes of this study was to determine the significance of hepatic vein waveform changes on doppler ultrasound in cirrhotic patients and to correlate with liver dysfunction. Materials and methods: This study was carried out in the department of Radiology and Imaging of Enam Medical College and Hospital during January 2017 to May 2018. Doppler waveforms were obtained from right hepatic vein in all the cases and classified as triphasic, biphasic and monophasic. Waveform comparisons were made among patients with differing grades of cirrhosis. Child- Pugh class was used to assess severity of cirrhosis. Doppler sonography was done in 80 patients suspecting of having liver cirrhosis. Data on clinical findings, B mode sonographic findings and hepatic vein doppler ultrasound findings were collected and documented in structured forms. Analysis was done using SPSS - 20. Results: Total of 80 patients who met the inclusion criteria are included in the study with mean age of 45.37±7.64 (range 25-75) years. Among these 57 (71%) were males while 23(29%) were females. On the basis of hepatic function 25 (31%) patients presented in Child-Pugh Class A, 31(39%) with Class B and 24(30%) patients had Class C. Hepatic venous waveform was triphasic in 22 (27.5%), biphasic in 28(35%), and monophasic in 30 (37.5%) cases. Our study revealed 88% (21) of Child- Pugh Class C, 23% (7) of Class B and 8% (2) of class A patients had monophasic HV waveform. The hepatic venous waveform progressively changed from triphasic to biphasic to monophasic with advancing grade of cirrhosis. The relationship of these waveforms change had significant relation with hepatic dysfunction (p < 0.022). Conclusion: Hepatic vein wave form changes reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of severity of liver cirrhosis. Thus, alteration in hepatic venous blood flow pattern on doppler ultrasound can be a useful noninvasive tool for evaluating diseases severity in patients with cirrhosis. J MEDICINE 2021; 22: 100-106

Health-related quality of life in patients with compensated and decompensated liver cirrhosis

2019 ◽  
Vol 70 ◽  
pp. 54-59 ◽  
Author(s):  
Christian Labenz ◽  
Gerrit Toenges ◽  
Jörn M. Schattenberg ◽  
Michael Nagel ◽  
Yvonne Huber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Liver Cirrhosis ◽  
Health Related Quality ◽  
Decompensated Liver Cirrhosis ◽  
Related Quality ◽  
Health Related

Photobacterium damselae subsp. damselae bacteraemia in a patient with liver cirrhosis

2021 ◽  
Vol 14 (6) ◽  
pp. e242580
Author(s):  
Satoshi Hayano ◽  
Takayuki Masaki ◽  
Risako Tadakuma ◽  
Masayuki Kashima
Keyword(s):  
Liver Cirrhosis ◽  
Soft Tissue ◽  
Blood Culture ◽  
Brackish Water ◽  
Immunocompromised Patients ◽  
Class B ◽  
Photobacterium Damselae ◽  
History Of ◽  
Pugh Class ◽  
Raw Fish

Photobacterium damselae subsp. damselae is a family of Vibrionaceae and exists in the marine environment. The organism rarely causes soft-tissue infection in humans; moreover, most of the infected individuals have a history of fishing or exposure to brackish water. We experienced the case of a 63-year-old patient with a history of liver cirrhosis (Child-Pugh class B) who presented with a fever and swelling of the left leg with pain. His symptoms developed after fishing and eating raw fish with exposure of brackish water. He was diagnosed with cellulitis, and Photobacterium damselae spp. damselae was detected in blood culture. The patient was treated with ceftazidime and minocycline and he was discharged after recovery. We need to be aware that in immunocompromised patients with cellulitis exposed to brackish water, organisms other than Staphylococci and Streptococci may be the causative organisms.

Quality of Life Score in Patients with Chronic Liver Disease using CLO Questionnaire

2021 ◽  
Vol 15 (11) ◽  
pp. 3467-3469
Author(s):  
Niaz Muhammad ◽  
Kashif Rafi ◽  
Hassan Nadeem ◽  
Muhammad Omer Farooq ◽  
Asmat Ullah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Life Score ◽  
Class B ◽  
Pugh Class ◽  
The Mean ◽  
Class C

Aim: To determine the quality of life score in patients with chronic liver disease using CLO questionnaire. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital Lahore during from 14-June-2016to 15-December-2016. Methodology: 180 consecutive patients of chronic liver disease were selected after taking Informed consent. The diagnosis was confirmed according to the data of clinical, biochemical examinations and the results of percutaneous liver biopsy data in some selected cases. All patients were subjected to exam, LFT's, RFT's and CBC, ultrasound abdomen, esophagogastroscopy which were enrolled in this study. Anti HCV, HBsAg, ferritin, Cerruloplasmin and Autoimmune profile, was done to establish the etiology. Severity of liver disease was estimated by Child-Pugh Score (Annexed). The chronic liver disease questionnaire (CLDQ) was applied as the instrument for measuring quality of life. Results: The mean age of the patients was 35.28±7.26 years. Majority of the patients were male as there frequency was 142 (78.9%). 127 (70.60 %) cases were found to be having a child pugh grade c severity of disease. Mean quality of life score was 16.3±5.88. Mean quality of life score in males was 16.21±6.21 while in female was 16.63±4.48. Similarly the mean quality of life score in child pugh class B was 13.77±4.58 and in child pugh class C was 17.35±6.05. Conclusion: It is concluded that the quality of life was bad in the patients who had child pugh class C as compared to those who had class B. Keywords: Quality of Life, Chronic Liver Disease, Cirrhosis

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