Elias Tamrat Petros, Shewaye Abate Bane, Fisseha Henok, Nur Abdulsemed Mohammed, Berhane Kaleb Assefa, Minyilshewa Asteray Tsige, Kumsa Kibrab Bulto, Seid Biruck Mohammed
Department of Internal Medicine, Adera Medical and Surgical Center, Addis Ababa, Ethiopia.
Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
PLoS One. 2025 Apr 29;20(4):e0322532. doi: 10.1371/journal.pone.0322532. eCollection 2025.
In Ethiopia, 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 of patients with liver cirrhosis are poorly understood. This study assessed the predictors of in-hospital mortality among cirrhotic patients in Ethiopia.
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. Paul's 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.
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%). 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 score (AOR: 1.17; 95% CI 1.05-1.30; P: 0.02), were found to be predictors of in-hospital mortality.
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.
在埃塞俄比亚，肝硬化是第六大主要死因，导致高住院率和死亡率。然而，迄今为止，影响肝硬化患者住院死亡率的因素尚不清楚。本研究评估了埃塞俄比亚肝硬化患者住院死亡率的预测因素。
一项回顾性横断面研究，使用从2023年1月1日至2024年3月31日在阿德拉医疗中心、圣保罗医院千禧医学院和提库尔·安贝萨专科医院内科病房因肝硬化并发症入院患者的电子病历中收集的数据。频率和交叉表用于描述性统计。在双变量分析中p值<0.25的预测变量纳入逻辑回归。
在最终分析纳入的299例患者中，大多数（79.6%）为男性，研究参与者的中位年龄为45岁（四分位间距，36 - 56岁）。乙型肝炎病毒（32.1%）是最常见的病因，其次是酒精（30.1%）和丙型肝炎病毒（13.4%）。腹水（69.2%）、上消化道出血（50.5%）和肝性脑病（44.8%）是最常见的表现形式。住院死亡率为25.4%。发现韦斯特黑文III级或IV级肝性脑病（比值比：12.0；95%置信区间2.33 - 61.63；P < 0.01）、肝细胞癌（比值比：9.05；95%置信区间2.18 - 37.14；P：0.01）、一年内既往住院史（比值比：6.80；95%置信区间2.18 - 21.18；P < 0.01）、急性肾损伤（比值比：6.47；95%置信区间1.77 - 23.64；P < 0.01）和终末期肝病 - 钠评分（比值比：1.17；95%置信区间1.05 - 1.30；P：0.02）是住院死亡率的预测因素。
埃塞俄比亚肝硬化患者的住院死亡率很高。韦斯特黑文III级或IV级肝性脑病是主要死因。因此，早期迅速识别和处理肝性脑病及其诱因对于获得更好的治疗效果和生存率至关重要。
