scholarly journals ALBI and Child-Pugh score in predicting mortality in chronic liver disease patients secondary to alcohol - A retrospective comparative study

2019 ◽  
Vol 10 (5) ◽  
pp. 33-36
Author(s):  
B S Nagaraja ◽  
R Madhumathi ◽  
S B Sanjeet ◽  
K J Umesh ◽  
S Kumar Nandish
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Liver Dysfunction ◽  
Age Distribution ◽  
Roc Curves ◽  
Meld Score ◽  
Chronic Liver ◽  
End Stage Liver Disease ◽  
Retrospective Comparative Study ◽  
End Stage

Background: The severity of liver dysfunction in chronic liver disease is often estimated with Child-Pugh (CTP) classification or model for end-stage liver disease (MELD) score. The albumin-bilirubin (ALBI) score is a new model for assessing the severity of liver dysfunction, which is simple and more objective. Aims and Objective: The present study was aimed to retrospectively compare the performance of ALBI score with Child-Pugh score for predicting the mortality in patients with chronic liver disease. Materials and Methods: Data of patients with chronic Liver disease irrespective of etiology were retrospectively reviewed. Child Pugh score and ALBI score were calculated for the patients and results from ROC curves were analysed. Results: Study conducted on 299 patients of chronic liver disease, age distribution was between 20-85 years with mean age of patients being 45.7+/-10.94 years, sex ratio male: female is 265:34 with mortality rate of 19.73%.The area under curves of ROC of ALBI and Child pugh are 0.586 and 0.549 respectively. Conclusion: Ability of ALBI score for predicting mortality was comparable with that of Child Pugh score but Child pugh score of more than 10 has got better performance of predicting mortality as compared to ALBI score.

A Study on Haematological Manifestations in Patients with Chronic Liver Disease in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (25) ◽  
pp. 2222-2228
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Jasleen Kaur ◽  
Navjot Kaur Layal ◽  
Gurkiran Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Meld Score ◽  
Chronic Liver ◽  
Care Hospital ◽  
End Stage Liver Disease ◽  
End Stage

BACKGROUND Chronic liver diseases frequently are associated with haematological abnormalities. Anaemia occurs in about 75% of patients with chronic liver disease. The most common type of anaemia seen in liver cirrhosis is normocytic normochromic anaemia, due to the chronic inflammatory state, blood loss from oesophageal and rectal varices. The purpose of this study was to study the haematological manifestations in patients with chronic liver disease. METHODS A cross-sectional observational study was conducted at Sri Guru Ram Das Institute of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients with chronic liver disease were included in the study. The population was divided into 2 groups based on the model for end-stage liver disease (MELD) score and the various haematological abnormalities were assessed in these 2 groups. Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the ChildTurcotte-Pugh (CTP) classification. RESULTS There was a significant correlation between hemoglobina and CTP class (P < 0.001), with the lowest haemoglobin levels in CTP class C group. The correlation coefficient of MELD score and haemoglobin was -0.504 which was significant statistically. Thus, confirming the fact that haemoglobin levels decreases with the progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8 g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis was observed in 41 patients and leucopoenia in 14 patients. The mean prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin time prolonged by more than 6 sec indicating liver damage alters coagulation profile. CONCLUSIONS We found an association between anaemia and indicators of advanced liver disease such as a higher MELD and CPS scores. This study inferred that levels of haemoglobin decrease as the severity of liver disease progresses. Thus, this measure can be used in the initial assessment of cirrhosis patients that needs urgent identification and correction to reduce morbidity and mortality. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class

scholarly journals Use of Granulocyte Colony-Stimulating Factor Among Patients of Chronic Liver Disease in a Tertiary Hospital in Nepal: A Pilot Study

2019 ◽  
Vol 18 (2) ◽  
pp. 53-59
Author(s):  
Rahul Pathak ◽  
Sabin Thapaliya
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Term Survival ◽  
End Stage Liver Disease ◽  
Standard Medical Therapy ◽  
End Stage ◽  
Stimulating Factor

Introduction: Granulocyte colony stimulating factor improves short-term survival and clinical outcomes in alcoholic hepatitis, acute-on-chronic liver failure and decompensated chronic liver disease. Our study aimed to assess survival benefit and change in Child-Turcotte-Pugh and Model For End-Stage Liver Disease scores 30 days after Granulocyte colony stimulating factor therapy in chronic liver disease patients, irrespective of their mode of presentation. Methods: This was a prospective observational study conducted in a university teaching hospital, where 25 patients with chronic liver disease were given 300 micrograms of Granulocyte colony stimulating factor subcutaneously 12 hourly plus standard medical therapy. We assessed survival until day 30. Child-Turcotte- Pugh and Model For End-Stage Liver Disease scores at enrolment and 30 days after treatment were compared. Results: 21 of 25 patients treated with Granulocyte colony stimulating factor survived at day 30. Treatment with Granulocyte colony stimulating factor reduced Child-Turcotte-Pugh score from 10.33 ± 1.24 to 8.76 ± 1.79 (p< 0.001) at day 30 and Model For End-Stage Liver Disease score from 22.10 ± 4.67 to 16.38 ± 5.52 (p < 0.001) at day 30. Conclusions: Granulocyte colony stimulating factor improves clinical outcome, Child-Turcotte-Pugh and Model For End-Stage Liver Disease scores in patients admitted with chronic liver disease for any cause. Further studies are needed to explore whether lower doses (total six doses) of Granulocyte colony stimulating factor are as effective as higher doses (total 10 doses). 

scholarly journals AST to platelet ratio index for predicting the in hospital mortality in chronic liver disease patients in tertiary care hospital

2019 ◽  
Vol 10 (4) ◽  
pp. 44-48
Author(s):  
BS Nagaraja ◽  
R Madhumati ◽  
HR Avinash ◽  
KJ Umesh
Keyword(s):  
Liver Disease ◽  
Hospital Mortality ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Age Distribution ◽  
Roc Curves ◽  
Chronic Liver ◽  
Care Hospital ◽  
Apri Score

Background: Liver cirrhosis is the end result of chronic liver injury. Cirrhosis of liver may progressively deteriorate from a well-compensated state to decompensated conditions. Aims and Objective: Our study aims at evaluating the AST to Platelet Ratio Index (APRI) for predicting the in-hospital mortality and also comparing APRI, MELD and albumin for predicting in hospital mortality in chronic liver disease. Materials and Methods: Data of Patients with Chronic liver disease were retrospectively reviewed. MELD and APRI scores were calculated for the patients and results from ROC curves were analysed. Results: In our study conducted on 299 patients, the age distribution was between 18-64 years with mean age of patients being 46.47+/-10.9 years, sex ratio Male: Female: 266:37 with mortality rate of 17.7%. The area under curves of ROC of APRI, MELD and Albumin are 0.63, 0.76 and 0.55. Conclusion: APRI is an independent predictor of mortality. The prognostic performance of all 3 was comparable but MELD has better prognostic significance than APRI score.

Model for End‐Stage Liver Disease‐Lactate and Prediction of Inpatient Mortality in Patients With Chronic Liver Disease

Hepatology ◽  
2020 ◽  
Vol 72 (5) ◽  
pp. 1747-1757 ◽  
Author(s):  
Naveed Sarmast ◽  
Gerald O. Ogola ◽  
Maria Kouznetsova ◽  
Michael D. Leise ◽  
Ranjeeta Bahirwani ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Inpatient Mortality ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Association of Chronic Liver Disease and Mortality in Patients With Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2021 ◽  
Author(s):  
Yu Zhang ◽  
Linjie Li ◽  
Lu Jia ◽  
Weelic Chong ◽  
Yang Hai ◽  
...  
Keyword(s):  
Liver Disease ◽  
Subarachnoid Hemorrhage ◽  
Chronic Liver Disease ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Chronic Liver ◽  
Disease Score ◽  
West China Hospital ◽  
End Stage Liver Disease ◽  
All Cause Mortality ◽  
End Stage

Background and Purpose: Chronic liver disease (CLD) is a risk factor for increased morbidity and mortality in acutely ill patients. For patients with aneurysmal subarachnoid hemorrhage (aSAH), the association between CLD and mortality remains unknown. Methods: In this retrospective cohort study, we analyzed consecutive aSAH patients admitted to the West China Hospital between 2009 and 2019. The primary outcome was in-hospital all-cause mortality. Results: This study included 6228 cases of aSAH, 489 (7.9%) of whom also had CLD. In a propensity-matched analysis, CLD was associated with increased mortality in patients with aSAH compared with non-CLD (odds ratio, 2.04 [95% CI, 1.43–2.92]). In aSAH patients with CLD, a high Model for End-Stage Liver Disease score was still associated with an increased odds of mortality. Conclusions: Among aSAH patients, CLD was associated with increased mortality compared with non-CLD. Among aSAH patients with CLD, a higher Model for End-Stage Liver Disease score was associated with an increased odds of mortality.

P3466Cardiac output in end-stage liver disease increases with the severity of liver dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A N Koshy ◽  
B Cailes ◽  
P Gow ◽  
A Testro ◽  
J K Sajeev ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Liver Disease ◽  
Cardiac Function ◽  
Liver Transplant ◽  
Liver Dysfunction ◽  
Meld Score ◽  
Left Ventricular ◽  
Cirrhotic Cardiomyopathy ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background End-stage liver disease is associated with significant systemic and haemodynamic alterations that affect cardiac function. Cirrhotic cardiomyopathy remains an ill-defined entity among cardiologists. Understanding the complex interplay between liver dysfunction and cardiac function can lead to a better understanding of the compensatory mechanisms of the heart in liver failure. Purpose To investigate whether severity of liver disease affects baseline cardiac output in a large contemporary cohort of patients undergoing liver transplant work-up. Methods Consecutive patients that underwent pre-liver transplant (LT) workup between 2010–2017 were included. All patients underwent a resting echocardiogram. Cardiac output (CO) was prospectively recorded at baseline by pulsed-wave Doppler examination of the left ventricular outflow tract from the apical window and systemic vascular resistance (SVR) was calculated as 80 x (mean arterial pressure (MAP)/CO). Severity of liver disease was characterized by the model of end-stage liver disease (MELD) and Child-Pugh scores. Results 560 patients were included (mean age 57.5±7.7, 74.8% male). Mean MELD score was 19±7 and Child-Pugh Score was 9±3. There was an inverse linear relationship between the severity of liver disease by the MELD score and baseline SVR (rho 0.40, P<0.001). As SVR reduced, there was also a significant rise in baseline CO with a strong inverse correlation between the two variables (rho 0.86, p<0.001). There was a significant linear correlation between the severity of liver disease and baseline CO with both the scores (MELD Score rho 0.42, p<0.001; Child Pugh rho 0.44, p<0.001) (Figure). Baseline CO in LT Patients by Severity Conclusions Baseline CO increased with the severity of liver dysfunction due to a reduced afterload. A higher resting CO may lead to patients encroaching on their cardiac reserve at rest. This provides a pathophysiological insight suggesting a limited role for beta-blockers, particularly in patients with advanced liver cirrhosis.

scholarly journals Association of Model for End-Stage Liver Disease Score and Mortality in Trauma Patients With Chronic Liver Disease

JAMA Surgery ◽  
2016 ◽  
Vol 151 (1) ◽  
pp. 41 ◽  
Author(s):  
Allan Peetz ◽  
Ali Salim ◽  
Reza Askari ◽  
Marc A. De Moya ◽  
Olubode A. Olufajo ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Trauma Patients ◽  
Disease Score ◽  
End Stage Liver Disease ◽  
End Stage
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