Modes of presentation and reasons of hospitalization for patients with decompensated chronic liver disease at civil hospital Karachi

ABSTRACT

To determine different modes of presentation and reasons that need hospitalization of patients with established chronic liver disease [CLD] and associate the presenting features with age, and severity of disease with the co-morbidity. Cross sectional, observational study. The study was conducted at Medical Wards of Civil Hospital, Karachi from July, 2006 to December, 2006. Patients who were admitted to the Medical Wards of Civil Hospital, Karachi and who already had established diagnosis of chronic liver disease were included in the study. Patient's charts were reviewed, Demographic information was noted from the charts and for more clarification, patients or their attendants were interviewed. The reason of hospitalization was noted. Different modes of presentations of chronic liver disease were analyzed and were compared with different demographic and clinical characteristics, using chi-square test. A total of 427 patients' charts were reviewed. Average ages of patients was 48.7 years. Hepatitis C was most common cause of CLD [64.6%]. Other causes included Hepatitis B [23.7%], both Hepatitis B and C [3%] and others [8.7%]. Majority of patients with CLO were hospitalized due to more than one signs and/or symptoms [63.5%], Common reasons of hospitalization in decreasing order were altered sensorium, hematemesis, abdominal distension, fever, abdominal pain and melena. More signs and symptoms of decompensation were seen in age groups 45-70 years [p=0.032]. Patients with any co-morbidity presented with greater number of sign and symptoms of decompensation when compared to patients without any co-morbidity [p=0.002]. No statistically significant association was found when presenting features of CLD were compared with duration of CLD and different co-morbidities. Hepatitis C was the common cause of CLD in this study. The reasons of hospitalization were a combination of neurological and gastrointestinal clinical features. These features did not associate with the duration of CLD or the cause of CLD