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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2023
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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. |
format | Online Article Text |
id | pubmed-10019520 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Dove |
record_format | MEDLINE/PubMed |
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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