Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia.
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| Format: | Artículo científico |
| Language: | en |
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Instituto Nacional de Salud
2023
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| author | Juan Luis Vélez |
| author_facet | Juan Luis Vélez |
| contents | Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia. Juan Luis Vélez Andrea Pérez Juan David Blanco Marie Claire Berrouet Lorena Valencia Sofía Soto Ana Sofía Ramírez Víctor Martínez Juan Luis Gallego Julia Jaillier Medicina hospital emergencies Liver cirrhosis health resources emergency service Introduction. Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care.Objective. To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medellín, Colombia.Materials and methods. This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics.Results. In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (± 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%).The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%).During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%.Conclusion. Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate. 2023 artículo científico 0120-4157 https://www.redalyc.org/articulo.oa?id=84377404002 https://www.redalyc.org/journal/843/84377404002/ https://www.redalyc.org/journal/843/84377404002/html/ https://www.redalyc.org/journal/843/84377404002/84377404002.epub https://www.redalyc.org/journal/843/84377404002/movil 10.7705/biomedica.6963 en http://www.redalyc.org/revista.oa?id=843 Biomédica application/pdf Instituto Nacional de Salud Biomédica (Colombia) Num.3 Vol.43 |
| format | Artículo científico |
| id | redalyc_84377404002 |
| institution | Redalyc |
| language | en |
| publishDate | 2023 |
| publisher | Instituto Nacional de Salud |
| spellingShingle | Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia. Juan Luis Vélez Medicina hospital emergencies Liver cirrhosis health resources emergency service Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia. Juan Luis Vélez Andrea Pérez Juan David Blanco Marie Claire Berrouet Lorena Valencia Sofía Soto Ana Sofía Ramírez Víctor Martínez Juan Luis Gallego Julia Jaillier Medicina hospital emergencies Liver cirrhosis health resources emergency service Introduction. Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care.Objective. To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medellín, Colombia.Materials and methods. This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics.Results. In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (± 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%).The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%).During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%.Conclusion. Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate. 2023 artículo científico 0120-4157 https://www.redalyc.org/articulo.oa?id=84377404002 https://www.redalyc.org/journal/843/84377404002/ https://www.redalyc.org/journal/843/84377404002/html/ https://www.redalyc.org/journal/843/84377404002/84377404002.epub https://www.redalyc.org/journal/843/84377404002/movil 10.7705/biomedica.6963 en http://www.redalyc.org/revista.oa?id=843 Biomédica application/pdf Instituto Nacional de Salud Biomédica (Colombia) Num.3 Vol.43 |
| title | Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia. |
| topic | Medicina hospital emergencies Liver cirrhosis health resources emergency service |
| url | https://www.redalyc.org/articulo.oa?id=84377404002 https://www.redalyc.org/journal/843/84377404002/ https://www.redalyc.org/journal/843/84377404002/html/ https://www.redalyc.org/journal/843/84377404002/84377404002.epub https://www.redalyc.org/journal/843/84377404002/movil |