학술논문
A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management
Document Type
article
Author
Julio D. Vorobioff; Fernando Contreras; Federico Tanno; Lucía Hernández; Fernando Bessone; Luis Colombato; José Adi; Eduardo Fassio; Mirta Felgueres; Guillermo Fernández; Luis Gaite; Diana Gibelli; Hernán Gómez Darrichon; Matías Lafage; Daniel Lombardo; Susana López; Alejandro Mateo; Manuel Mendizábal; Julieta Pecoraro; Andrés Ruf; Pablo Ruiz; Javier Severini; Teodoro Stieben; Marcela Sixto; Fabián Zárate; Sergio de la Barra Barraza; Irene Donoso Sierra; Violeta Rivas Pacheco; Juan P. Roblero; Juan O. Rojas; Patricio Ruiz González; Diego San Martín Rodríguez; Armando Sierralta; Alvaro Urzúa Manchego; Eliana Valdes; Pamela Yaquich; Rodrigo Wolff; Flor Beltran Valdivia; Roxana C. Gallegos; Rocío Galloso; Julio S. Marcelo; Pedro Montes; Laura Tenorio; Isabel Veramendi; Elizabeth Alava; Ximena Armijos; Gonzalo Benalcazar; Enrique Carrera; Galo F. Pazmiño; Eduardo Marriott Díaz; Miguel Garassini; Rosalía P. Marrero; Mirta Infante; Dayron Páez Suárez; José C. Gutiérrez; Carmen M. Villadoniga Reyes; Yoel M. Serrano; Rivardo Hernández Hernández; Orelvis Martínez Martínez; Teresita Pérez González; María T. Andara; Marco Sánchez Hernández; Solange Gerona; Iván García; Fátima de la Tijera; Edmundo Pessoa López; Kenia Torres; Martín Garzón
Source
Annals of Hepatology, Vol 19, Iss 4, Pp 396-403 (2020)
Subject
Language
English
ISSN
1665-2681
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.