TITLE:
Mortality Factors for Cirrhotics in an Ivorian University Hospital (Ivory Coast)
AUTHORS:
Jean Baptiste Okon, Mamadou Diakite, Fabrice Ake, Olivier Koffi Kouadio, Amadou Kone
KEYWORDS:
Cirrhosis, Hepatocellular Carcinoma, Mortality, CHU Bouake
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.10 No.9,
September
7,
2020
ABSTRACT: Background: Cirrhosis, an ineluctable development of chronic liver disease, still has
high mortality throughout the world despite many advances in physiopathology
and therapy. This high mortality is closely related to the unpredictable
course of cirrhosis with numerous complications. Objective: To evaluate the predictive factors of death during cirrhosis. Materials
and methods: This is an observational, descriptive study on cirrhotic
patients hospitalized in the hepatology unit of the Center Hospitalier
Universitaire in Bouake (Ivory Coast) during the period from January 01, 2018
to December 31, 2019. The study focused on the data collected in the medical
files (paper format) of hospitalized cirrhotics and the death register of the
service. The
diagnosis of cirrhosis and the death of the cirrhotic were the main criteria
for judgment. The secondary criteria defined were: history of cirrhosis,
reasons for consultation, clinical signs, biological signs, complications of
cirrhosis and the treatment received. The relationship between the parameters was
expressed as an odds ratio (OR) with a 95% confidence interval (CI) and the
significance threshold fixed at p 0.05. Results: The study retained 206 files
of cirrhotics including 146 men and 60 women. The hospital prevalence of cirrhosis was 44.17% and
the mortality rate was 42.23%. The
deceased patients were mainly men with an average age of 49 years. The etiologies of
cirrhosis were dominated by viral hepatitis B, chronic alcohol poisoning and
viral hepatitis C, respectively 46.95%, 37.35% and 10.84%. The predictors of
death were: the presence of icterus (OR = 1.89, 95%CI [1.08 - 3.30],
p = 0.036), hepatic encephalopathy (OR = 8.75, 95%CI [4.51 - 16.94],
p = 2.23, 95%CI [1.25 - 3.98],
p =
0.010); the presence in the biology of hepatic cytolysis (OR = 2.57, 95%CI [1.35 - 4.89], p = 0.006), severe hepatocellular insufficiency (OR = 2.57, 95%CI [1.38 - 4.77], p = 0.004), severe renal insufficiency (OR = 2.41, 95%CI [1.09 - 5.32], p = 0.044) and hyperleukocytosis (OR = 2.28, 95%CI [1.29 - 4.04],
p =
0.007); Child-Pugh stage C (OR =
19.64, 95%CI
[9.02 - 42.74], p 0.001); the presence on ultrasound of large liver and variable nodules (OR = 4.16, 95%CI [2.02 - 8.58], p Conclusion: Cirrhosis
is a public health problem at the Bouake university hospiler center.
Decompensated and complicated old cirrhosis, hepatic cytolysis, severe
hepatocellular insufficiency, severe renal insufficiency and hyperleukocytosis,
heterogeneous nodular large liver are the detrimental factors.