scholarly journals Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase - platelet ratio index.

2020 ◽  
Author(s):  
Yvonne Ayerki Nartey ◽  
Yaw Asante Awuku ◽  
Adwoa Agyei-Nkansah ◽  
Amoako Duah ◽  
Sally Afua Bampoh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Cross Sectional Study ◽  
Alpha Fetoprotein ◽  
Sub Saharan Africa ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Patient Profile ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background: End-stage liver disease (ESLD) is a major burden on public health, particularly in sub-Saharan Africa, where hepatitis B virus (HBV) is an important risk factor. We aimed to describe clinical characteristics of ESLD from cirrhosis or hepatocellular carcinoma (HCC) and the performance of aspartate aminotransferase (AST) - platelet ratio index (APRI) and alpha fetoprotein (AFP) in Ghana. Methods: We performed an observational cross-sectional study in outpatient hepatology clinics at three teaching hospitals in Ghana, West Africa. One hundred and forty-one HCC, 216 cirrhosis and 218 chronic HBV patients were recruited by convenience sampling. Sociodemographic, history and examination, laboratory, and disease staging information were shown using descriptive statistics. Performance of the APRI score in diagnosis of cirrhosis and AFP in the diagnosis of HCC was determined using AUROC analysis.Results: Median age at presentation was 44 years for HCC and 46 years for cirrhosis. HBV was found in 69.5% of HCC and 47.2% of cirrhosis cases, and HCV in 6.4% and 3.7% respectively. APRI cut-off of 2 had sensitivity of 45.4% and specificity of 95% in diagnosis of cirrhosis, and cut-off of 1 had sensitivity of 75.9% and specificity of 89%. AUC of AFP was 0.88 (95% CI 0.81-0.94) in diagnosis of HCC. Low monthly income was associated with lower odds of undertaking AFP. Thirty one percent of cirrhotic persons were Child-Pugh C, and 67.9% of HCC patients had advanced or terminal disease at presentation. Conclusions: Our findings emphasize the young age of ESLD patients in Ghana and the advanced nature at presentation. It highlights shortcomings in surveillance and the need for policies to address the burden and improve outcomes in Ghana.

scholarly journals Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase: platelet ratio index

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yvonne Ayerki Nartey ◽  
Yaw Asante Awuku ◽  
Adwoa Agyei-Nkansah ◽  
Amoako Duah ◽  
Sally Afua Bampoh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Cross Sectional Study ◽  
Alpha Fetoprotein ◽  
Sub Saharan Africa ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Patient Profile ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background End-stage liver disease (ESLD) is a major burden on public health, particularly in sub-Saharan Africa, where hepatitis B virus (HBV) is an important risk factor. We aimed to describe clinical characteristics of ESLD from cirrhosis or hepatocellular carcinoma (HCC) and the performance of aspartate aminotransferase (AST)—platelet ratio index (APRI) and alpha fetoprotein (AFP) in Ghana. Methods We performed an observational cross-sectional study in outpatient hepatology clinics at three teaching hospitals in Ghana, West Africa. One hundred and forty-one HCC, 216 cirrhosis and 218 chronic HBV patients were recruited by convenience sampling. Sociodemographic, history and examination, laboratory, and disease staging information were shown using descriptive statistics. Performance of the APRI score in diagnosis of cirrhosis and AFP in the diagnosis of HCC was determined using AUROC analysis. Results Median age at presentation was 44 years for HCC and 46 years for cirrhosis. HBV was found in 69.5% of HCC and 47.2% of cirrhosis cases, and HCV in 6.4% and 3.7% respectively. APRI cut-off of 2 had sensitivity of 45.4% and specificity of 95% in diagnosis of cirrhosis, and cut-off of 1 had sensitivity of 75.9% and specificity of 89%. AUC of AFP was 0.88 (95% CI 0.81–0.94) in diagnosis of HCC. Low monthly income was associated with lower odds of undertaking AFP. Thirty one percent of cirrhotic persons were Child–Pugh C, and 67.9% of HCC patients had advanced or terminal disease at presentation. Conclusions Our findings emphasize the young age of ESLD patients in Ghana and the advanced nature at presentation. It highlights shortcomings in surveillance and the need for policies to address the burden and improve outcomes in Ghana.

scholarly journals Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase - platelet ratio index

2020 ◽  
Author(s):  
Yvonne Ayerki Nartey ◽  
Yaw Asante Awuku ◽  
Adwoa Agyei-Nkansah ◽  
Amoako Duah ◽  
Sally Afuah Bampoh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Cross Sectional Study ◽  
Alpha Fetoprotein ◽  
Sub Saharan Africa ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Patient Profile ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background: End-stage liver disease (ESLD) is a major burden on public health, particularly in sub-Saharan Africa, where hepatitis B virus (HBV) is an important risk factor. We aimed to describe clinical characteristics of ESLD from cirrhosis or hepatocellular carcinoma (HCC) and the performance of aspartate aminotransferase (AST) - platelet ratio index (APRI) and alpha fetoprotein (AFP) in Ghana. Methods: We performed an observational cross-sectional study in outpatient hepatology clinics at three teaching hospitals in Ghana, West Africa. One hundred and forty-one HCC, 216 cirrhosis and 218 chronic HBV patients were recruited by convenience sampling. Sociodemographic, history and examination, laboratory, and disease staging information were shown using descriptive statistics. Performance of the APRI score in diagnosis of cirrhosis and Alpha fetoprotein in the diagnosis of HCC was determined using AUROC analysis.Results: Median age at presentation was 44 years for HCC and 46 years for cirrhosis. HBV was found in 69.5% of HCC and 47.2% of cirrhosis cases, and HCV in 6.4% and 3.7% respectively. APRI cut-off of 2 had sensitivity of 45.4% and specificity of 95% in diagnosis of cirrhosis, and cut-off of 1 had sensitivity of 75.9% and specificity of 89%. AUC of AFP was 0.88 (95% CI 0.81-0.94) in diagnosis of HCC. Low monthly income was associated with lower odds of undertaking AFP. Thirty one percent of cirrhotic persons were Child-Pugh C, and 67.9% of HCC patients had advanced or terminal disease at presentation. Conclusions: Our findings emphasize the young age of ESLD patients in Ghana and the advanced nature at presentation. It highlights shortcomings in surveillance and the need for policies to address the burden and improve outcomes in Ghana.

scholarly journals Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase - platelet ratio index.

2020 ◽  
Author(s):  
Yvonne Ayerki Nartey ◽  
Yaw Asante Awuku ◽  
Adwoa Agyei-Nkansah ◽  
Amoako Duah ◽  
Sally Afuah Bampoh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Cross Sectional Study ◽  
Alpha Fetoprotein ◽  
Sub Saharan Africa ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Patient Profile ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background: End-stage liver disease (ESLD) is a major burden on public health, particularly in sub-Saharan Africa, where hepatitis B virus (HBV) is an important risk factor. We aimed to describe clinical characteristics of ESLD from cirrhosis or hepatocellular carcinoma (HCC) and the performance of aspartate aminotransferase (AST) - platelet ratio index (APRI) and alpha fetoprotein (AFP) in Ghana. Methods: We performed an observational cross-sectional study in outpatient hepatology clinics at three teaching hospitals in Ghana, West Africa. One hundred and forty-one HCC, 216 cirrhosis and 218 chronic HBV patients were recruited by convenience sampling. Sociodemographic, history and examination, laboratory, and disease staging information were shown using descriptive statistics. Performance of the APRI score in diagnosis of cirrhosis and AFP in the diagnosis of HCC was determined using AUROC analysis.Results: Median age at presentation was 44 years for HCC and 46 years for cirrhosis. HBV was found in 69.5% of HCC and 47.2% of cirrhosis cases, and HCV in 6.4% and 3.7% respectively. APRI cut-off of 2 had sensitivity of 45.4% and specificity of 95% in diagnosis of cirrhosis, and cut-off of 1 had sensitivity of 75.9% and specificity of 89%. AUC of AFP was 0.88 (95% CI 0.81-0.94) in diagnosis of HCC. Low monthly income was associated with lower odds of undertaking AFP. Thirty one percent of cirrhotic persons were Child-Pugh C, and 67.9% of HCC patients had advanced or terminal disease at presentation. Conclusions: Our findings emphasize the young age of ESLD patients in Ghana and the advanced nature at presentation. It highlights shortcomings in surveillance and the need for policies to address the burden and improve outcomes in Ghana.

scholarly journals Evaluation of Mortality Risk in Liver Cirrhosis with Albumin- Bilirubin (Albi), Platelet-Albumin-Bilirubin (Palbi), and Fibrosis-4 (Fib-4) Scores

2021 ◽  
Vol 14 (02) ◽  
pp. 985-991
Author(s):  
D.A. Sindhughosa ◽  
I.K. Mariadi ◽  
I.D.N. Wibawa ◽  
I.G.A. Suryadarma ◽  
N. Purwadi ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Mortality Risk ◽  
Liver Diseases ◽  
Cross Sectional Study ◽  
Meld Score ◽  
Sectional Study ◽  
Cross Sectional ◽  
End Stage Liver Disease ◽  
End Stage

Background:The model for end stage liver disease (MELD) score considered as a reliable predictor of survival for advanced liver diseases patients. Among several chemistry laboratorium examinations, albumin, bilirubin and platelet reflect the function of the liver. Objectives: To investigate the correlation of albumin-bilirubin (ALBI), platelet-albumin-bilirubin (PALBI), and fibrosis-4 (FIB-4) scores with mortality risk based on MELD score and evaluate their role in predictingcirrhosis mortality risk. Methods: The analytic cross-sectional study designrecruited adults with liver cirrhosis of any etiology during the period of November 2018 through January 2019. Descriptive and correlative analyses were done before proceeding to diagnostic abilityanalysis. Results: Sixty-two patients with mean age of 52.95 ± 12.05 were included in the analysis. The ALBI, PALBI, and FIB-4 scores were significantly correlated with higher mortality risk based on MELD score. The three scoressignificantly predicted higher mortality risk with varying sensitivity and specificity. Conclusion: Positivecorrelation between ALBI, PALBI, and FIB-4 scores with MELD score was found. ALBI (≥-1.26), PALBI (≥-2.05), and FIB-4 (≥5.84) values higher than the thresholdcould predict mortality risk in cirrhosis.

scholarly journals Psychological, Cognitive, and Laboratory Characteristics of End-Stage Liver Disease Patients

2020 ◽  
Vol 20 (8) ◽  
Author(s):  
Mahmadsharif Mirgoziev ◽  
Mohammad Baghernezhad ◽  
Seyed Ali Malek Hosseini ◽  
Mohsen Rezaee ◽  
Zohre Ansarinia ◽  
...  
Keyword(s):  
Liver Disease ◽  
Verbal Learning ◽  
Laboratory Data ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Cued Recall ◽  
Short Delay ◽  
Cross Sectional ◽  
End Stage Liver Disease ◽  
End Stage

Background: End-Stage Liver Disease (ESLD) causes several clinical and psychological comorbidities. Some accompanying psychiatric disturbances have significant effects on the patients’ quality of life. Objectives: Thus, we aimed to evaluate some psychological characteristics of ESLD patients. Methods: A cross-sectional study was conducted on 91 ESLD patients aged 18 - 70 years. We assessed the patients using the California Verbal Learning Test (CVLT), Fatigue Severity Scale, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale. Also, we measured the demographic and some laboratory data of the participants. The data were analyzed by SPSS version 21 software, and P values of less than 0.05 were considered significant. Results: The study included 68 men and 23 women with a mean age of 41.9 ± 13.72 years (range 19 - 68). The mean scores of fatigue (40.6 ± 14.8) and anxiety (12.98 ± 2.76) were more than the normal range. The most significant association was seen between age and CVLT items (attention (P = 0.01), immediate memory (P < 0.001), short delay free recall (0.01), and short delay cued recall (0.03). Conclusions: End-stage liver disease patients had anxiety, fatigue, and memory disorders in addition to their poor clinical conditions. Although the main treatment of ESLD is liver transplantation but the psychological and cognitive problems before transplantation in these patients are prognostic factors for post-operation compliance and follow up.

scholarly journals CLINICAL AND LABORATORIAL CHARACTERISTICS OF THE LIVER IN AGED AND NON-AGED ALCOHOLICS

2019 ◽  
Vol 12 (3) ◽  
pp. 521
Author(s):  
Paulo Borini ◽  
Romeu Cardoso Guimarães ◽  
Zamir Calamita
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Reference Value ◽  
Cross Sectional Study ◽  
Gamma Glutamyl Transferase ◽  
Aged Patients ◽  
Cross Sectional ◽  
Glutamyl Transferase

The medical bibliography is deficient in research involving structural and laboratory abnormalities of the liver in asymptomatic and oligosymptomatic male alcoholics. The present study describes the alterations in tests that evaluate liver aggression, lesion and dysfunction, also correlating these with the changes in the consistency and sensitivity of the liver in aged and non-aged alcoholics. Cross-sectional study involving 100 alcoholic men, 50 aged and 50 non-aged. Of the aged and non-aged, respectively, the liver was palpable in 68% and 80%, the spleen was percutable in 72% and 74% and palpable in 12% and 22%, non-painful soft hepatomegaly was observed in 14% and 8%, painful hepatomegaly in 0% and 2%, firm hepatomegaly (painful and non-painful) in 54% and 70%, hepatomegaly and splenomegaly (percutable and palpable spleen) in 84% and 84%, and portal hypertension in 10 % and 14%. Elevated levels of aspartate aminotransferase were observed in 66% and 84%, alanine aminotransferase in 24% and 60%, gamma glutamyl transferase in 46% and 82% and alkaline phosphatase in 0% and 16% of the aged and non-aged, respectively. Elevation of aspartate aminotransferase greater than twice the reference value and the ratio aspartate aminotransferase to alanine aminotransferase greater than 2 were observed in 18% and 42% and 18% and 10% of the aged and non-aged, respectively. Hypoalbuminemia and hyperbilirubinemia were observed in 70% and 24% of the aged and 40% and 44% of the non-aged, respectively. The clinical and laboratory alterations observed are compatible with acute liver disease in 18% and 42%; chronic liver disease in 54% and 70%; portal hypertension in 10% and 14% of aged and non-aged patients, respectively.

Model for End-stage Liver Disease (MELD) in spontaneous bacterial peritonitis –a clinical study at a tertiary health center in Nepal

2013 ◽  
Vol 2 (2) ◽  
pp. 47-51
Author(s):  
Rahul Pathak ◽  
Kiran Niraula ◽  
Prem Krishna Khadga ◽  
Kumar Vikram Singh ◽  
Ishwar Sharma
Keyword(s):  
Liver Disease ◽  
Spontaneous Bacterial Peritonitis ◽  
Adverse Outcomes ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Urea Level ◽  
Predictors Of Mortality ◽  
Bacterial Peritonitis ◽  
End Stage Liver Disease ◽  
End Stage

Background and Aims: The aim of this study was to assess the predictive value of different variables including the Model of End-stage Liver Disease (MELD) scores in hospitalized patients with spontaneous bacterial peritonitis (SBP) and its correlation with adverse outcomes. Methods: A cross-sectional study of 73 patients diagnosed with cirrhosis, ascites, and spontaneous bacterial peritonitis admitted to a gastroenterology department from February 2010 to November 2012. MELD scores were calculated using laboratory parameters and the United Network of Organ Sharing (UNOS) internet MELD tool. Results: Categorical variables and mortality status were analyzed for association by chi-square test. MELD scores and all-cause mortality were found to be positively correlated. Mortality was higher among the groups with MELD scores greater than 15. Upon stratification of the groups by mortality status, only age and urea level were novel and consistent predictors of mortality. Conclusions: In this Nepalese sample of cirrhotic patients, MELD scores along with age and urea level were confirmed as significant predictors of mortality. DOI: http://dx.doi.org/10.3126/jaim.v2i2.8776  J ournal of Advances in Internal Medicine 2013;02(02):47-51

A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit

2016 ◽  
Vol 35 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Giulia-Anna Perri ◽  
Herman Yeung ◽  
Yoel Green ◽  
Abby Bezant ◽  
Carman Lee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Liver Disease ◽  
Pain Management ◽  
Care Facility ◽  
Palliative Care Unit ◽  
Or Education ◽  
Cross Sectional ◽  
End Stage Liver Disease ◽  
Knowledge And Attitudes ◽  
End Stage

Background: Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD. Methods: A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the “Nurses Knowledge and Attitudes Survey Regarding Pain” (NKASRP) tool. Results: Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level. Conclusions: The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.

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