Study of Clinico-Aetiological Profile in Patients of Liver Cirrhosis in a Tertiary Care Hospital of North India

Abstract

BACKGROUND Cirrhosis is a chronic disease of liver marked by degeneration of cells, inflammation and fibrous thickening of the tissue. It is a common cause of morbidity and mortality. Globally, the incidence of liver cirrhosis is on the rise. Therefore, the exact knowledge of aetiology, mode of clinical presentation, and pattern of development of complications of cirrhosis will help in optimal and costeffective control measures of this disease. We undertook this study to evaluate the cause and mode of presentation of patients with liver cirrhosis presenting in a tertiary care hospital of North India. We also wanted to determine biochemical changes in liver cirrhosis. METHODS This observational prospective study was conducted in the Department of Medicine over a period of one year, it included 122 cirrhotic patients of both sexes between 18 and 75 years irrespective of aetiology who fulfilled inclusion criteria. After detailed medical history and thorough physical examination, relevant laboratory investigations, ultrasound of abdomen, and upper GI endoscopy was done. Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease ( MELD) score was calculated. The recorded data was analysed statistically. RESULTS Out of 122 patients, 85.2 % were males and 14.8 % were females. Maximum number of patients 33.60 % were in 41 - 50 years of age. Alcohol was found to be the most common aetiological factor in 80.3 % patients. The most common presenting symptom was abdominal distension in 89.9 % patients. Various complications such as spontaneous bacterial peritonitis was present in 13.9 %, anaemia in 93.4 %, thrombocytopenia 75.4 %, deranged international normalized ratio (INR) 78.6 %, deranged renal function 45.9 %, hyponatremia in 35.2 % patients. Maximum number of patients 72.9 % were in CTP class C. 68 % patientshad MELD score > 14. CONCLUSIONS Males are mainly affected by liver cirrhosis due to excessive alcohol consumption therefore proper preventive measures have to be taken. The raised total leucocyte count (TLC), serum bilirubin, serum creatinine, decreased serum albumin, serum sodium and coagulopathy were found to be poor prognostic markers. KEYWORDS Cirrhosis, Aetiology, Complications, Prognosis