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

2020; Elsevier BV; Volume: 19; Issue: 4 Linguagem: Inglês

10.1016/j.aohep.2020.03.007

2659-5982

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

Hepatitis Viruses Studies and Epidemiology

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. A cross sectional, multicenter survey of hospitalized cirrhotic patients. 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). 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.