The Prevalence, Predictors, and In-Hospital Mortality of Hepatic Encephalopathy in Patients with Liver Cirrhosis Admitted at St. Dominic Hospital in Akwatia, Ghana

Background. Hepatic encephalopathy (HE) is one of the most debilitating complications of cirrhosis leading to death. Decrease in HE mortality and recurrence has been linked with timely identification and early treatment. There is a need to document the burden, predictors, and treatment outcomes of HE in an adult population with liver cirrhosis in our setting as only reports from resource-endowed countries abound in the literature. This study aimed therefore to determine the prevalence, predictors, and treatment outcomes of patients with liver cirrhosis admitted at St. Dominic Hospital (SDH) in Akwatia, Ghana. Materials and Methods. A prospective study was conducted involving one hundred and sixty-seven (167) patients admitted at the medical wards in SDH with liver cirrhosis from January 1st, 2018, to March 24th, 2020. The demographic and clinical features of the patients were collected using a standardized questionnaire. Biochemical, haematological, and abdominal ultrasound scans were done for all patients. Patients were then followed up until discharge or death. Results. There were 109 (65.3%) males out of the 167 patients with a mean age of 45.8 and 47.5 years for those with and without HE, respectively. The prevalence of HE was 31.7% (53/167). Out of 53 participants with HE, 75.5% (40/53) died. There was a strong association between HE and death (p<0.001). The major precipitating factor of HE was infection (64.2%). Severe ascites (OR = 0.009) were clinical feature independently associated with HE, whereas high creatinine (OR = 0.987), blood urea nitrogen (BUN) (OR = 1.199), Child–Pugh score (CPS) (OR = 5.899), and low platelets (OR = 0.992) were the laboratory parameters and scores independently predictive of HE. Conclusion. HE was common among patients with liver cirrhosis admitted at SDH with high in-patient mortality. The commonest precipitating factor for HE was infection(s). Severe ascites, low platelet count, high creatinine, BUN, and CPS were independent predictors of HE

Bacterial Infections in Patients with Liver Cirrhosis: Prevalence, Predictors, and in-Hospital Mortality at a District Hospital in Ghana

BackgroundIn-patients with liver cirrhosis, bacterial infections are common with high in-hospital mortality. In Ghana, bacterial infections in liver cirrhosis patients and their impact on in-patient mortality are generally unknown. This study was conducted to define the prevalence, predictors, and treatment outcomes of cirrhotic patients with bacterial infections admitted to a district hospital in Ghana. MethodsPatients with liver cirrhosis hospitalized from 1st January, 2018 to 24th April, 2020 were consecutively recruited. The demographic data and clinical presentations of the patients were collected using standardized questionnaire. Full blood count, liver function test, renal function test, ascitic fluid analysis and culture, urinalysis and culture, hepatitis B surface antigen, anti-hepatitis C antibodies and abdominal ultrasound scans of the abdomen were conducted for all patients. ResultsThere were 110 (65.09%) males out of the 169 patients with a mean age of 47.10±12.88 years. The prevalence of infections was 42.01% (71/169). Out of 71 participants with infections, 59.15% (42/72) died. Fever, encephalopathy, high white cell count, Child-Pugh Class C and Blood urea nitrogen were independent predictors of bacterial infections ConclusionBacterial infection among the participants admitted to district hospital with liver cirrhosis was common with high in-hospital mortality. Rwanda J Med Health Sci 2022;5(1):46-5