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Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort

BACKGROUND: Cirrhosis is a pathology responsible for a significant hospital morbidity and mortality. The objective of this study was to determine the factors associated with hospital mortality in a sample of Malagasy cirrhotics. PATIENTS AND METHODS: This was a retrospective cohort study from Januar...

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Autores principales: Razafindrazoto, Chantelli Iamblaudiot, Randriamifidy, Nitah Harivony, Ralaizanaka, Behoavy Mahafaly, Andrianoelison, Jean Tsitamita, Ravelomanantsoa, Haga Tsilavo, Rakotomaharo, Mialitiana, Hasina Laingonirina, Domoina Harivonjy, Maherison, Sonny, Rakotomalala, Jolivet Auguste, Rasolonjatovo, Anjaramalala Sitraka, Rakotozafindrabe, Andry Lalaina Rinà, Rabenjanahary, Tovo Harimanana, Razafimahefa, Soloniaina Hélio, Ramanampamonjy, Rado Manitrala
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019520/
https://www.ncbi.nlm.nih.gov/pubmed/36938483
http://dx.doi.org/10.2147/HMER.S401628
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author Razafindrazoto, Chantelli Iamblaudiot
Randriamifidy, Nitah Harivony
Ralaizanaka, Behoavy Mahafaly
Andrianoelison, Jean Tsitamita
Ravelomanantsoa, Haga Tsilavo
Rakotomaharo, Mialitiana
Hasina Laingonirina, Domoina Harivonjy
Maherison, Sonny
Rakotomalala, Jolivet Auguste
Rasolonjatovo, Anjaramalala Sitraka
Rakotozafindrabe, Andry Lalaina Rinà
Rabenjanahary, Tovo Harimanana
Razafimahefa, Soloniaina Hélio
Ramanampamonjy, Rado Manitrala
author_facet Razafindrazoto, Chantelli Iamblaudiot
Randriamifidy, Nitah Harivony
Ralaizanaka, Behoavy Mahafaly
Andrianoelison, Jean Tsitamita
Ravelomanantsoa, Haga Tsilavo
Rakotomaharo, Mialitiana
Hasina Laingonirina, Domoina Harivonjy
Maherison, Sonny
Rakotomalala, Jolivet Auguste
Rasolonjatovo, Anjaramalala Sitraka
Rakotozafindrabe, Andry Lalaina Rinà
Rabenjanahary, Tovo Harimanana
Razafimahefa, Soloniaina Hélio
Ramanampamonjy, Rado Manitrala
author_sort Razafindrazoto, Chantelli Iamblaudiot
collection PubMed
description BACKGROUND: Cirrhosis is a pathology responsible for a significant hospital morbidity and mortality. The objective of this study was to determine the factors associated with hospital mortality in a sample of Malagasy cirrhotics. PATIENTS AND METHODS: This was a retrospective cohort study from January 2018 to August 2020 conducted in the Hepato-Gastroenterology Unity, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. RESULTS: One hundred and eight patients were included. The mean age was 51.13±13.50 years with a sex ratio of 2.37. The etiology of cirrhosis was dominated by alcohol (44.44%), hepatitis B virus (24.07%) and hepatitis C virus (13.89%). Twenty-eight patients (25.93%) had died. Factors associated with in-hospital mortality were hepatic encephalopathy (OR: 14.16; 95% CI: 5.08–39.4; p: 0.000), renal failure (OR: 8.55; 95% CI: 2.03–39.9; p: 0.0034), gastrointestinal bleeding (OR: 3.25; 95% CI: 1.32–7.92; p: 0.0099), hyponatraemia <130mmol/L (OR: 3.34; 95% CI: 1.04–10.6; p=0.046), Child-Pugh C classification (OR: 0.19; 95% CI: 0.12–0.21; p: 0.000), and MELD-Na score >32 (OR: 27.5; 95% CI: 4.32–174.8; p: 0.004). CONCLUSION: The in-hospital mortality rate during acute decompensation of cirrhosis remains high in Madagascar. Hepatic encephalopathy, renal failure, GI bleeding and hyponatraemia are the main clinico-biological factors affecting in-hospital mortality. Early intervention on these modifiable factors is an important step to improve hospital outcomes. The natraemia, MELD score and MELD-Na score should be used in routine practice in Madagascar to identify patients with acute decompensation of cirrhosis at high risk of death.
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spelling pubmed-100195202023-03-17 Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort Razafindrazoto, Chantelli Iamblaudiot Randriamifidy, Nitah Harivony Ralaizanaka, Behoavy Mahafaly Andrianoelison, Jean Tsitamita Ravelomanantsoa, Haga Tsilavo Rakotomaharo, Mialitiana Hasina Laingonirina, Domoina Harivonjy Maherison, Sonny Rakotomalala, Jolivet Auguste Rasolonjatovo, Anjaramalala Sitraka Rakotozafindrabe, Andry Lalaina Rinà Rabenjanahary, Tovo Harimanana Razafimahefa, Soloniaina Hélio Ramanampamonjy, Rado Manitrala Hepat Med Original Research BACKGROUND: Cirrhosis is a pathology responsible for a significant hospital morbidity and mortality. The objective of this study was to determine the factors associated with hospital mortality in a sample of Malagasy cirrhotics. PATIENTS AND METHODS: This was a retrospective cohort study from January 2018 to August 2020 conducted in the Hepato-Gastroenterology Unity, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. RESULTS: One hundred and eight patients were included. The mean age was 51.13±13.50 years with a sex ratio of 2.37. The etiology of cirrhosis was dominated by alcohol (44.44%), hepatitis B virus (24.07%) and hepatitis C virus (13.89%). Twenty-eight patients (25.93%) had died. Factors associated with in-hospital mortality were hepatic encephalopathy (OR: 14.16; 95% CI: 5.08–39.4; p: 0.000), renal failure (OR: 8.55; 95% CI: 2.03–39.9; p: 0.0034), gastrointestinal bleeding (OR: 3.25; 95% CI: 1.32–7.92; p: 0.0099), hyponatraemia <130mmol/L (OR: 3.34; 95% CI: 1.04–10.6; p=0.046), Child-Pugh C classification (OR: 0.19; 95% CI: 0.12–0.21; p: 0.000), and MELD-Na score >32 (OR: 27.5; 95% CI: 4.32–174.8; p: 0.004). CONCLUSION: The in-hospital mortality rate during acute decompensation of cirrhosis remains high in Madagascar. Hepatic encephalopathy, renal failure, GI bleeding and hyponatraemia are the main clinico-biological factors affecting in-hospital mortality. Early intervention on these modifiable factors is an important step to improve hospital outcomes. The natraemia, MELD score and MELD-Na score should be used in routine practice in Madagascar to identify patients with acute decompensation of cirrhosis at high risk of death. Dove 2023-03-12 /pmc/articles/PMC10019520/ /pubmed/36938483 http://dx.doi.org/10.2147/HMER.S401628 Text en © 2023 Razafindrazoto et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Razafindrazoto, Chantelli Iamblaudiot
Randriamifidy, Nitah Harivony
Ralaizanaka, Behoavy Mahafaly
Andrianoelison, Jean Tsitamita
Ravelomanantsoa, Haga Tsilavo
Rakotomaharo, Mialitiana
Hasina Laingonirina, Domoina Harivonjy
Maherison, Sonny
Rakotomalala, Jolivet Auguste
Rasolonjatovo, Anjaramalala Sitraka
Rakotozafindrabe, Andry Lalaina Rinà
Rabenjanahary, Tovo Harimanana
Razafimahefa, Soloniaina Hélio
Ramanampamonjy, Rado Manitrala
Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort
title Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort
title_full Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort
title_fullStr Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort
title_full_unstemmed Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort
title_short Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort
title_sort factors associated with in-hospital mortality in malagasy patients with acute decompensation of liver cirrhosis: a retrospective cohort
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019520/
https://www.ncbi.nlm.nih.gov/pubmed/36938483
http://dx.doi.org/10.2147/HMER.S401628
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