MODES OF PRESENTATION AND REASONS OF HOSPITALIZATION FOR PATIENTS WITH DECOMPENSATED CHRONIC LIVER DISEASE AT CIVIL HOSPITAL KARACHI

• Main Authors: Dileep K, Jaipal J, Ameer A. Khowaja, Khalid Mahmood, Kanya Lal Ahuja
• Format: Article
• Language: English
• Published: Dow University of Health Sciences 2008-04-01
• Series: Journal of the Dow University of Health Sciences
• Subjects: chronic liver disease; hepatitis; hospitalization
• Online Access: http://www.jduhs.com/index.php/jduhs/article/view/235
• ISSN: 1995-2198; 2410-2180

OBJECTIVE: To determine different modes of presentation and reasons that need hospitalization of patientswith established chronic liver disease (CLD) and associate the presenting features with age, and severityof disease with the co-morbidity. Design: Cross sectional, observational study Patients And Methods: 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 andwho already had established diagnosis of chronic liver disease were included in the study. Patient’s chartswere reviewed. Demographic information was noted from the charts and for more clarification, patients ortheir attendants were interviewed. The reason of hospitalization was noted. Different modes of presentationsof chronic liver disease were analyzed and were compared with different demographic and clinicalcharacteristics, using chi-square test. Results: A total of 427 patients’ charts were reviewed. Average ages of patients was 48.7 years. HepatitisC was most common cause of CLD (64.6%). Other causes included Hepatitis B (23.7%), both Hepatitis Band C (3%) and others (8.7%). Majority of patients with CLD were hospitalized due to more than one signsand/or symptoms (63.5%). Common reasons ofhospitalization in decreasing order were altered sensorium,hematemesis, abdominal distension, fever, abdominal pain and melena. More signs and symptoms ofdecompensation were seen in age groups 45-70 years (p=0.032). Patients with any co-morbidity presentedwith greater number of signs and symptoms of decompensation when compared to patients without any comorbidity(p=0.002). No statistically significant association was found when presenting features of CLDwere compared with duration of CLD and different co-morbidities. Conclusion: Hepatitis C was the common cause of CLD in this study. The reasons ofhospitalization werea combination of neurological and gastrointestinal clinical features. These features did not associate withthe duration of CLD or the cause of CLD.