Objectives: The present study aimed to determine the effect of tracheobronchial aspiration on hospitalization outcomes and the factors influencing its occurrence. Methods: This prospective descriptive study was conducted from January 2017 to December 2020 at GMC/DHQ-Teaching Hospital in Gujranwala, Pakistan. All consenting liver cirrhosis patients with hepatic encephalopathy > 12 years of age admitted at the study site were included. The patient’s baseline characteristics and the hospitalization outcomes were noted in terms of death and discharge. The collected data was analyzed using SPSS version 22.0. The predictors of tracheobronchial aspiration were determined using Independent Sample T test and Chi-square test for quantitative and qualitative variables respectively. The p-values were taken statistically significant if < 0.05. A binary logistic regression analysis was performed to ascertain the effect of significant factors on the likelihood of tracheobronchial aspiration. Results: Among the total of 294 patients, 28.0% died during hospitalization. Death occurred significantly more in group of patients who had tracheobronchial aspiration (62.7% vs 12.0%, p<0.01). Increasing age was associated with increased chance of tracheobronchial aspiration (p<0.01). Male gender (49.6% vs 8.2%, p<0.01), patients whose hepatic encephalopathy was precipitated by upper GI bleed (59.7% vs 22.9%, p<0.01), and patients with comorbidities (p=0.02) were significantly prone to tracheobronchial aspiration. Conclusions: Tracheobronchial aspiration is a significant predictor of inpatient mortality among patients with hepatic encephalopathy. Male gender, increasing age & upper GI bleed predict aspiration in hepatic encephalopathy patients. doi: https://doi.org/10.12669/pjms.38.4.5114 How to cite this:Rafiq Q, Zeeshan M, Mustafa G, Irfan M. Tracheobronchial aspiration affects the outcome of hospitalization among Hepatic Encephalopathy patients. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5114 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: To determine the factors affecting the outcome of hospitalization in patients suffering liver cirrhosis hospitalized to tertiary care hospital, Gujranwala, Pakistan. Methods: After informed consent, the data of liver cirrhosis patients with age >12 years hospitalized from June 2016 to May 2017 was collected by purposive sampling. The outcome of the hospitalization in term of ‘death’ and ‘no death’ was noted. Statistical analysis was done using SPSS version 25. Bivariate analysis as well binary logistic regression was performed to ascertain the effect of different predictors like gender, age, history of diabetes mellitus, etiology of cirrhosis, presence of hepatic encephalopathy at presentation, presence of upper GI bleed, and tracheobronchial aspiration on the likelihood that death would be the outcome in liver cirrhosis patients. Results: Amongst total of 1304 patients, 15.7% died during hospitalization. The mean age of those who died was 58.08 + 14.49 years. Bivariate analysis suggested that mortality was significantly higher in group of patients who had hepatic encephalopathy at presentation (p<0.01), no upper gi bleed (p<0.01), and who got tracheobronchial aspiration during hospitalization (p<0.01). It did not differ significantly in male/female gender (p=0.504), diabetic/non-diabetic groups (p=0.652), with viral/non-viral etiology of cirrhosis (p=0.918). Binary logistic regression revealed that patients who had tracheobronchial aspiration were 12.392 times more likely to die than who had no tracheobronchial aspiration. Similarly, patients who presented in hepatic encephalopathy were 7.862 times more likely to die than who presented without hepatic encephalopathy. Conclusion: The inpatient mortality rate amongst cirrhotic patients was high. Age, gender, history of diabetes, viral etiology of cirrhosis did not significantly contribute in the mortality of these patients. The patients who presented in hepatic encephalopathy, and who suffered tracheobronchial aspiration during hospitalization were more likely to die. Excellence in hepatic encephalopathy management and prevention from aspiration can effectively reduce the mortality rate of cirrhotic patients in our hospitals. doi: https://doi.org/10.12669/pjms.35.5.884 How to cite this:Irfan M, Mahmud Y, Khan RMS, Rafiq Q, Nadeem MA, Mohsin A. Factors affecting the outcome of hospitalization among liver cirrhosis patients. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.884 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: To determine the role of TRANEXAMIC ACID in prevention of primary postpartum haemorrhage in women. Study Design: Observational Retrospective Cohort Design. Settings: DHQ Hospital, Gujranwala. Period: April 2016 to July 2018. Material & Methods: The data of 110 women who suffered postpartum haemorrhage was retrieved from the hospital records. Exclusion criteria included all the females who were below and equal to 18 years of age. Patients suffering from acute respiratory distress syndrome (ARDS), on long-term anti-inflammatory and steroid therapy were also excluded. Whereas all the women who had experienced postpartum haemorrhage after birth were included. Results: We retrieved data of 110 women who had experienced postpartum haemorrhage after birth. The age of participants was averaged 28.95 + 7.6 years. The group I was named as early treatment group and contained 35 women whereas the group II (late treatment or without TRANEXAMIC ACID) had 75 women. The mean age of women is higher in the group I i.e. 30.2 +6.8 than 27.7+8.4. The TRANEXAMIC ACID was given intravenously with an average dose of 1 gram (0.1-3.0 grams) 1.5 hours after the birth. This was an average time for all cases in group I. The average time was 4.6 hours in group II. Conclusion: We concluded that use of intravenous TRANEXAMIC ACID in postpartum haemorrhage is associated with reduced haemorrhage but a low dose at early treatment may not yield good results.
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