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1. A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management

Author

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

Subjects
Survey, Cirrhosis, Decompensation, Ascites, Specialties of internal medicine, RC581-951
Abstract

Introduction & objectives: Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes. 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.

Published
2020
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2. A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management

Author

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

Subjects
Liver Cirrhosis, Male, Cirrhosis, Specialties of internal medicine, Autoimmune hepatitis, Decompensation, 0302 clinical medicine, Liver Cirrhosis, Alcoholic, Non-alcoholic Fatty Liver Disease, Surveys and Questionnaires, Epidemiology, Survey, Hepatic encephalopathy, Aged, 80 and over, education.field_of_study, Ascites, General Medicine, Bacterial Infections, Middle Aged, Hospitalization, Hepatitis, Autoimmune, RC581-951, 030220 oncology & carcinogenesis, Health Resources, 030211 gastroenterology & hepatology, Female, Gastrointestinal Hemorrhage, Adult, medicine.medical_specialty, Gastrointestinal bleeding, Population, Peritonitis, 03 medical and health sciences, Young Adult, Spontaneous bacterial peritonitis, Age Distribution, medicine, Diabetes Mellitus, Humans, Obesity, Sex Distribution, education, Aged, Hepatology, business.industry, Hepatitis C, Chronic, medicine.disease, Latin America, Hepatic Encephalopathy, Emergency medicine, Etiology, business
Abstract

Introduction & objectives Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes. 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.

Published
2020

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