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