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Chronic liver disease related mortality pattern in Northern Pakistan
1Department of Medicine, Shifa International Hospital and Shifa College of Medicine, Islamabad, Pakistan. drnkhokhar@yahoo.com
Insights
Chronic liver disease (CLD) significantly contributes to mortality in Northern Pakistan, with Hepatitis C Virus (HCV) being the primary cause. This study highlights the disease
Area of Science:
- Hepatology
- Public Health
- Epidemiology
Background:
- Chronic liver disease (CLD) poses a significant health burden globally.
- Understanding mortality patterns is crucial for public health interventions.
Purpose of the Study:
- To delineate the mortality patterns associated with chronic liver disease (CLD) in Northern Pakistan.
- To identify the primary etiologies and clinical presentations of CLD-related deaths.
Main Methods:
- A descriptive study analyzing 12 months of admission data from a tertiary care hospital in Islamabad.
- Review of medical mortality cases to identify CLD patients and analyze their presentation, severity, and etiology.
- Statistical analysis of demographic and clinical data.
Main Results:
- CLD accounted for 20.6% of medical deaths (33 out of 160 deaths).
- Hepatitis C Virus (HCV) was the leading cause (70%), followed by Hepatitis B Virus (HBV) (12%) and co-infection (9%).
- Common presentations included gastrointestinal bleeding (36%), ascites (27%), and hepatic encephalopathy (18%).
Conclusions:
- CLD represents a major cause of mortality in Northern Pakistan, particularly in tertiary care settings.
- HCV infection is the predominant etiology of CLD, followed by HBV.
- Gastrointestinal bleeding, hepatic failure, and portal hypertension are key clinical manifestations leading to mortality.
Objective:
To describe the mortality pattern pertaining to chronic liver disease (CLD) in Northern Pakistan.
Design:
descriptive study.
Place And Duration Of Study:
Shifa International Hospital, Islamabad, from August 01, 2001 to July 31, 2002.
Subjects And Methods:
Twelve months admission data was reviewed from its computerized data base. All cases pertaining to medical mortality were reviewed. Out of these cases, patients of chronic liver disease were identified and their mode of presentation, severity of illness and etiology of their chronic liver disease were statistically analyzed.
Results:
There were a total of 8529 admissions in twelve months period from August 2001 to July 2002. There were 283 (3.31%) total deaths. Out of these, 160 deaths were pertaining to medical causes. Out of these medical cases, 33 (20.6%) patients had died of chronic liver disease. Other major causes of death were cerebro-vascular accident (18.7%), malignancy (18.1%) and acute myocardial infarction (10.6%). Out of 33 patients of CLD, 12 (36%) presented with acute gastrointestinal (GI) bleeding, 9 (27%) presented with ascites and 6(18%) presented with altered mental status due to hepatic encephalopathy. Rest of them had jaundice and fever as their initial presentation. Out of these 33 patients with CLD, 23 (70%) had hepatitis C virus (HCV) as cause of their liver disease, 4 (12%) had hepatitis B virus (HBV) infection, 3 (9%) had both hepatitis B and hepatitis C virus infections and 3 (9%) had no known cause of their chronic liver disease.
Conclusion:
Chronic liver disease is a major cause of mortality in this part of Pakistan at a tertiary care hospital. HCV infection is the main cause of chronic liver disease followed by either HBV or a combination of these viruses. Major manifestations of CLD have been gastrointestinal bleeding, hepatic failure and portal hypertension.