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Abstract：
BACKGROUND: The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India\'s 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients.
METHODS: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed.
RESULTS: Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality.
CONCLUSIONS: Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups.
METHODS: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed.
RESULTS: Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality.
CONCLUSIONS: Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups.
摘要：
背景：世界卫生组织（WHO）报告说，亚洲和非洲的慢性肝病（CLD）死亡率最高。肝硬化,每10万人死亡22.2人，是印度第10大最常见的死亡原因。慢性肝病患病率的增加需要进行一项研究，以确定访问急诊科的患者的预测因素。在急诊科中，确定提高CLD并发症不稳定患者死亡率预测价值的因素很重要。本研究旨在确定临床和实验室参数作为成人慢性肝病患者的死亡率预测因子。
方法：这项研究是在印度北部三级医疗中心的急诊科进行的。对符合纳入标准的18岁以上慢性肝病患者进行临床评估。收集临床和人口统计细节，并对数据进行了分析。
结果：招募了2336名患者。平均年龄为50.77±14.26岁。78.4%的参与者是男性。腹胀,影响59.7%的患者，是最常见的疾病，接着是黑便和呕血,影响41.9%和32.6%，分别。在急诊科的平均停留时间为10.29±8.10h。难治性脓毒性休克，死亡的主要原因，占所有死亡人数的69.2%,除了4级肝性脑病和大量上消化道（UGI）出血，正如我们研究中所确定的那样。诸如改变的精神感觉，高呼吸率，血氧饱和度低心率加快,收缩压低,低舒张压,急诊科（ED）到达的格拉斯哥昏迷量表（GCS）低与死亡率显着相关。
结论：慢性肝病，在印度很普遍,最常见于中年男子和较低的社会经济群体。在我们的研究中，与死亡率独立相关的参数是存在改变的精神感觉，格拉斯哥昏迷量表,ChildPugh班，需要入住ICU。了解演示模式，和死亡率预测因子可以帮助ED医生管理急性事件和随访。
方法：这项研究是在印度北部三级医疗中心的急诊科进行的。对符合纳入标准的18岁以上慢性肝病患者进行临床评估。收集临床和人口统计细节，并对数据进行了分析。
结果：招募了2336名患者。平均年龄为50.77±14.26岁。78.4%的参与者是男性。腹胀,影响59.7%的患者，是最常见的疾病，接着是黑便和呕血,影响41.9%和32.6%，分别。在急诊科的平均停留时间为10.29±8.10h。难治性脓毒性休克，死亡的主要原因，占所有死亡人数的69.2%,除了4级肝性脑病和大量上消化道（UGI）出血，正如我们研究中所确定的那样。诸如改变的精神感觉，高呼吸率，血氧饱和度低心率加快,收缩压低,低舒张压,急诊科（ED）到达的格拉斯哥昏迷量表（GCS）低与死亡率显着相关。
结论：慢性肝病，在印度很普遍,最常见于中年男子和较低的社会经济群体。在我们的研究中，与死亡率独立相关的参数是存在改变的精神感觉，格拉斯哥昏迷量表,ChildPugh班，需要入住ICU。了解演示模式，和死亡率预测因子可以帮助ED医生管理急性事件和随访。
