ABSTRACT
INTRODUCTION & OBJECTIVES: Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes. METHODS: A cross sectional, multicenter survey of hospitalized cirrhotic patients. RESULTS: 377 patients, (62% males; 58±11 years) (BMI>25, 57%; diabetes 32%) were hospitalized at 65 centers (63 urbans; 57 academically affiliated) in 13 countries on the survey date. Main admission causes were ascites, gastrointestinal bleeding, hepatic encephalopathy and spontaneous bacterial peritonitis/other infections. Most prevalent etiologies were alcohol-related (AR) (40%); non-alcoholic-steatohepatitis (NASH) (23%), hepatitis C virus infection (HCV) (7%) and autoimmune hepatitis (AIH) (6%). The most frequent concurrent etiologies were AR+NASH. Expertise and resources in every analyzed issue were highly available among participating centers, mostly accomplishing valid guidelines. However, availability of these facilities was significantly higher at institutions located in areas with population>500,000 (n=45) and in those having a higher complexity level (Gastrointestinal, Liver and Internal Medicine Departments at the same hospital (n=22). CONCLUSIONS: The epidemiological etiologic profile in hospitalized, decompensated cirrhotic patients in Latin America is similar to main contemporary emergent agents worldwide. Medical and technical resources are highly available, mostly at great population urban areas and high complexity medical centers. Main diagnostic and therapeutic approaches accomplish current guidelines recommendations.
Subject(s)
Ascites/epidemiology , Gastrointestinal Hemorrhage/epidemiology , Hepatic Encephalopathy/epidemiology , Hospitalization , Liver Cirrhosis/epidemiology , Peritonitis/epidemiology , Adult , Age Distribution , Aged , Aged, 80 and over , Ascites/etiology , Bacterial Infections , Diabetes Mellitus/epidemiology , Female , Gastrointestinal Hemorrhage/etiology , Health Resources , Hepatic Encephalopathy/etiology , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/epidemiology , Hepatitis, Autoimmune/complications , Hepatitis, Autoimmune/epidemiology , Humans , Latin America/epidemiology , Liver Cirrhosis/complications , Liver Cirrhosis, Alcoholic/complications , Liver Cirrhosis, Alcoholic/epidemiology , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/epidemiology , Obesity/epidemiology , Peritonitis/etiology , Sex Distribution , Surveys and Questionnaires , Young AdultABSTRACT
A 60 year old male patient having systemic scleroderma and normotensive scleroderma renal crisis was admitted in our hospital. He presented polyarticular, esophagic, lung and skin compromise. Before admission he had been treated with high doses of corticosteroids. We believe corticosteroids led to the worsening of renal damage with renal failure, microangiopathic hemolytic anemia without high blood pressure. The 10% of these cases have normal blood pressure. The patient was treated with enalapril and hemodialysis. There was no favourable response to this treatment and he died seven days after admission.
Subject(s)
Acute Kidney Injury/chemically induced , Adrenal Cortex Hormones/adverse effects , Scleroderma, Systemic/complications , Anemia, Hemolytic/chemically induced , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Blood Pressure , Enalapril/therapeutic use , Fatal Outcome , Humans , Male , Middle Aged , Renal Dialysis , Scleroderma, Systemic/drug therapyABSTRACT
A 60 year old male patient having systemic scleroderma and normotensive scleroderma renal crisis was admitted in our hospital. He presented polyarticular, esophagic, lung and skin compromise. Before admission he had been treated with high doses of corticosteroids. We believe corticosteroids led to the worsening of renal damage with renal failure, microangiopathic hemolytic anemia without high blood pressure. The 10% of these cases have normal blood pressure. The patient was treated with enalapril and hemodialysis. There was no favourable response to this treatment and he died seven days after admission
Subject(s)
Humans , Male , Middle Aged , Acute Kidney Injury , Adrenal Cortex Hormones , Scleroderma, Systemic , Anemia, Hemolytic , Angiotensin-Converting Enzyme Inhibitors , Enalapril , Fatal Outcome , Renal Dialysis , Scleroderma, SystemicABSTRACT
A 60 year old male patient having systemic scleroderma and normotensive scleroderma renal crisis was admitted in our hospital. He presented polyarticular, esophagic, lung and skin compromise. Before admission he had been treated with high doses of corticosteroids. We believe corticosteroids led to the worsening of renal damage with renal failure, microangiopathic hemolytic anemia without high blood pressure. The 10% of these cases have normal blood pressure. The patient was treated with enalapril and hemodialysis. There was no favourable response to this treatment and he died seven days after admission (AU)
Subject(s)
Humans , Male , Middle Aged , Scleroderma, Systemic/complications , Acute Kidney Injury/chemically induced , Adrenal Cortex Hormones/adverse effects , Scleroderma, Systemic/drug therapy , Fatal Outcome , Renal Dialysis , Anemia, Hemolytic/chemically induced , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Enalapril/therapeutic useABSTRACT
A 60 year old male patient having systemic scleroderma and normotensive scleroderma renal crisis was admitted in our hospital. He presented polyarticular, esophagic, lung and skin compromise. Before admission he had been treated with high doses of corticosteroids. We believe corticosteroids led to the worsening of renal damage with renal failure, microangiopathic hemolytic anemia without high blood pressure. The 10
of these cases have normal blood pressure. The patient was treated with enalapril and hemodialysis. There was no favourable response to this treatment and he died seven days after admission.
