Assessment of Severity of Cirrhosis in Hospitalized Patients

Abstract

Background: To assess the severity of cirrhosis at the time of presentation to hospital and to seek
association between sociocultural, demographic and geographic variables and severity of chronic liver
disease.
Materials & Methods: One hundred consecutive cases of cirrhosis of liver admitted in Nishtar Hospital,
Multan were included in this study. After history, physical examination and relevant investigations, patients
were segregated into Child grade A, B and C depending upon the severity of liver disease.
Results:Among 100 cases studied, 48 were male and 52 female; the mean age was 47 years (range 20 to
80 years). Majority of the patients were from low socio economic group. Out of 100 cases 72% were from
rural areas and 28% were from urban areas. It was found that most of the patients (92%) presented to
hospital when their liver disease was advanced (46 patients of Child grade B and 46 patients of Child grade
C) while only 8 patients had mild liver disease (Child Grade A). Rural population had more severe disease at
the time of presentation as compared to urban population. Poor & middle socioeconomic group had more
severe and advanced chronic liver disease as compared to rich class (p=0.0306). It was found that female
had more severe disease at the time of presentation (P=0.0346). Frequency of cirrhosis was found to be
more above 40 years of age.
Conclusion: Results of this study indicated that cases of cirrhosis of liver are referred to tertiary care units
when their disease is advanced with serious complications. Moreover there is a significant association
between geographic and socioeconomic status of the patients and severity of cirrhosis. It is recommended
that health care personnel should be properly trained for health education and early recognition and referral
of the patients of chronic liver disease to tertiary care units. This will prevent complications and will help to
decrease the morbidity and mortality