Clinical Profile of Patients with Chronic Liver Disease and the Predictors of Hospital Mortality at Muhimbili National Hospital

Abstract

Background: Chronic liver disease (CLD) is the term used to describe disordered liver function for 6 or more months. It results from progressive destruction and regeneration of liver parenchyma and encompasses a variety of liver pathologies leading to cirrhosis and hepatocellular carcinoma. Commonest cause of CLD is viral hepatitis (HBV AND HCV) and alcohol misuse. It develops gradually with imprecise clinical presentation and as a result lead to late diagnosis. Therefore, initial presentation with clinically decompensated liver disease is common. Objective: To describe patient characteristics and predictors of hospital mortality. Patients and methods: A cross-sectional hospital-based study conducted for a period of 6 months starting from November 2020 to April 2021, the study population comprised of consenting adults with clinical and radiological evidence of chronic liver disease. Semistructured interviews were designed to obtain information, association was tested using chi-square with a P value of 0.05 accepted for significance. Results: There were 123 patients with chronic liver disease in this study. Mean age of respondents was 48± 14 years with a male to female ratio of 2.6:1. Majority of patients had HBV infection, 56% had cirrhosis, HCC 29%, and cirrhosis with HCC 15%. Subjects had a mean MELD score of 15.6±8.7 and most patients were in Child Turcotte Pugh score class B and C. Having MELD between 9-19 and higher or Child Turcotte Pugh class B and C was associated with increased in-hospital mortality. Conclusion: Majority of subjects had a HBV infection, as per clinical profile most presented with decompensated liver function, from our results MELD and Child Pugh could predict mortality and patients that will benefit of liver transplant.