Mortality burden due to liver cirrhosis and hepatocellular carcinoma in Ghana; prevalence of risk factors and predictors of poor in-hospital survival

Nartey, Yvonne Ayerki; Antwi, Samuel O.; Bockarie, Ansumana Sandy; Hiebert, Lindsey; Njuguna, Henry; Ward, John W.; Awuku, Yaw Asante; Plymoth, Amelie; Roberts, Lewis R.

doi:10.1371/journal.pone.0274544

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…HCC was the other predictor of hospital mortality in this study. Similar findings were reported in other Sub-Saharan African countries such as Ivory Coast and Ghana (13,43). However, the presence of HCC was not found to be a predictor of in-hospital mortality in research done in the US (14).…”

Section: Discussionsupporting

confidence: 85%

Predictors of In-hospital Mortality among Cirrhotic Patients in Ethiopia: A Multicenter Retrospective Study

Elias,

Shewaye,

Chichaybelu

et al. 2024

Preprint

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Background: Cirrhosis is a major global health problem and a leading cause of liver-related mortality. In Ethiopia specifically, cirrhosis is the 6th leading cause of death and is responsible for high hospitalization and mortality rates. However, until now, factors affecting in–hospital mortality in patients admitted due to complications of liver cirrhosis are poorly understood. This study assessed the predictors of in–hospital mortality among cirrhotic patients in Ethiopia. Methods: A retrospective cross–sectional study using data collected from the electronic medical records of patients who were admitted for complications of liver cirrhosis between January 1, 2023, and March 31, 2024, in the medical wards of Adera Medical Center, St. Pauls Hospital Millennium Medical College, and Tikur Anbessa Specialized Hospital. Frequency and cross-tabulation were used for descriptive statistics. Predictor variables with a p-value <0.25 in bivariate analyses were included in the logistic regression. The adjusted odds ratio (AOR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of the association. A p-value <0.05 was considered statistically significant. Results: Of the 299 patients included in the final analysis, the majority (79.6%) were males, and the median age of the study participants was 45 (IQR, 36–56) years. Hepatitis B virus (32.1%) was the most common etiology, followed by alcohol (30.1%) and hepatitis C virus (13.4%). More than half (52.9%) of the patients were in Child-Pugh class C, and around a quarter (26.1%) of the patients had comorbidities. Ascites (69.2%), Upper gastrointestinal bleeding (50.5%), and hepatic encephalopathy (44.8%) were the most common forms of presentation. The in–hospital mortality rate was 25.4%. West Haven Grade III or IV hepatic encephalopathy (AOR: 12.0; 95% CI 2.33 – 61.63; P <0.01), Hepatocellular Carcinoma (AOR: 9.05; 95% CI 2.18 – 37.14; P: 0.01), History of previous admission within one year period (AOR: 6.80; 95% CI 2.18 – 21.18; P <0.01), Acute Kidney Injury (AOR: 6.47; 95% CI 1.77 – 23.64; P <0.01), and Model for End–Stage Liver Disease– Sodium (MELD–Na) Score (AOR: 1.17; 95% CI 1.05 – 1.30; P: 0.02), were found to be predictors of in–hospital mortality. Conclusion: In–hospital mortality of cirrhotic patients is high in Ethiopia. West Haven grade III or IV hepatic encephalopathy is the leading cause of mortality. Hence, Prompt identification and management of hepatic encephalopathy and its precipitant at an earlier stage is crucial for better treatment outcomes and survival. Keywords: Cirrhosis, In–hospital mortality, Ethiopia

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Section: Discussionsupporting

confidence: 85%

Predictors of In-hospital Mortality among Cirrhotic Patients in Ethiopia: A Multicenter Retrospective Study

Elias,

Shewaye,

Chichaybelu

et al. 2024

Preprint

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“…This poses the problem of vaccination coverage against viral hepatitis B. The predominance of hepatitis B virus infection is also reported by El-Kass [18] in Egypt, Nartey et al [19] in Ghana and Somé et al [16] in Burkina Faso. A low prevalence of viral hepatitis B virus infection in liver cancer is reported by Giannitrapani et al [20] in Italy, Endo et al [21] in Japan and Lui Yet al [22] in China.…”

Section: Discussionmentioning

confidence: 69%

Profile of people living with cancer followed in the palliative care unit of Parakou, Benin in 2021

ALASSANI¹,

DOVONOU²,

SAKE³

et al. 2023

World J. Adv. Res. Rev.

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Introduction: Cancer is a global public health problem. This study focused on the the profile of people living with cancer in Parakou. Study method: This was a cross-sectional, descriptive and analytical study which enrolled people living with cancer followed in the palliative heath care of the internal medicine unit at the Regional University Health Center of Borgou who had given their consent. The variables of the study were: sociodemographic data, nutritional status, comorbidities, circumstances of cancer screening and their location. Data analysis was performed using Epi Data 3.1 software. Results: The study population consisted of 264 people with cancer. A male predominance was observed with a sex ratio of 2.66. The average age was 47.51 years ±13.20. Alcohol consumption was observed in 15.2%. Arterial hypertension was found in 63.6% of subjects. On the nutritional level, malnutrition and weight loss were observed respectively in 68.2% and 98.1% of patients. Abdominal pain, asthenia and weight loss were the main circumstances for cancer screening and were present in 37.1%, 27.6% and 16.7% of participants respectively. Liver cancer was found in the majority (72%) of the participants. Viral hepatitis B was the most common cause with 98.3% Conclusion: cancer affects young adults and is often detected at an advanced stage. The main site is the liver and infection with the hepatitis B virus is found in most of the cases.

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“…Frontiers in Pharmacology frontiersin.org Liver cirrhosis is a major health problem and one of the top 10 causes of death worldwide. It is a predisposing factor for hepatic failure and HCC (Nartey et al, 2022). The underlying etiologies are various, such as the administration of some drugs, viral infection, alcohol consumption, fatty liver, and some autoimmune diseases.…”

Section: Effect Of Different Treatments On Hepatic Content Of Hydroxy...mentioning

confidence: 99%

A new cirrhotic animal protocol combining carbon tetrachloride with methotrexate to address limitations of the currently used chemical-induced models

et al. 2023

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Background: Chemically induced cirrhotic animal models are commonly used. However, they have limitations such as high mortalities and low yield of cirrhotic animals that limit their uses.Aims: To overcome limitations of the chemically induced cirrhotic animal model via combined administration of methotrexate (MTX) with CCl4 and decrease their commonly used doses depending on the proposed synergetic cirrhotic effect.Methods: Rats were divided into six groups: normal (4 weeks), normal (8 weeks), MTX, CCl4 (4 weeks), CCl4 (8 weeks), and MTX + CCl4 (4 weeks) groups. Animals’ hepatic morphology and histopathological characterization were explored. Hepatic Bcl2 and NF-κB-p65 tissue contents were determined using the immunostaining technique, and hepatic tissue damage, oxidative status, and inflammatory status biochemical parameters were determined.Results: CCl4 + MTX combined administration produced prominent cirrhotic liver changes, further confirmed by a substantial increase in oxidative stress and inflammatory parameters, whereas mortalities were significantly lower than in other treated groups.Conclusion: The present study introduced a new model that can significantly improve the major limitations of chemically induced cirrhotic animal models with new pathological features that mimic human cirrhosis. Compared to other chemically induced methods, the present model can save time, cost, and animal suffering.

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Mortality burden due to liver cirrhosis and hepatocellular carcinoma in Ghana; prevalence of risk factors and predictors of poor in-hospital survival

Cited by 11 publications

References 31 publications

Predictors of In-hospital Mortality among Cirrhotic Patients in Ethiopia: A Multicenter Retrospective Study

Predictors of In-hospital Mortality among Cirrhotic Patients in Ethiopia: A Multicenter Retrospective Study

Profile of people living with cancer followed in the palliative care unit of Parakou, Benin in 2021

A new cirrhotic animal protocol combining carbon tetrachloride with methotrexate to address limitations of the currently used chemical-induced models

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