Caracterizacón epidemiológica, clínica y sobrevida de los pacientes con cirrocis hepática. Hospital Teodoro Maldonado Carbo período enero 2016 - diciembre 2020
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: Existe poco consenso respecto a la sobrevida global y factores asociados entre individuos con cirrosis hepática de distintas fases de compensación y etiologías. Por otro lado, la gran mayoría de estos estudios proceden de poblaciones anglosajonas o europeas. Existe al momento escasa literatura actualizada en pacientes de Latinoamérica, especialmente del Ecuador. Objetivo: Establecer los factores asociados para con la sobrevida global en pacientes con cirrosis hepática atendidos en un nosocomio referente de la ciudad de Guayaquil – Ecuador entre enero del 2016 a diciembre del 2020. Metodología: Estudio observacional, analítico, longitudinal prospectivo, de recuperación retrospectiva, del tipo cohorte histórica. Se llevará a cabo en el Hospital Teodoro Maldonado Carbo (HTMC), entre enero del 2016 a diciembre del 2020. Se llevará a cabo en pacientes con diagnóstico establecido de cirrosis hepática a partir de hallazgos clínicos, de laboratorio (ej: plaquetopenia), ecográficos (ej: disminución del tamaño hepático, esplenomegalia) y/o endoscópicos (várices esofágicas); de cualquier etiología. Las distintas variables de estudio serán recuperadas a partir del sistema informático e historias clínicas individuales del nosocomio anfitrión (HTMC). La información será almacenada en una hoja electrónica, encriptada y en línea, compatible con MS Access. Resultados: Se recuperó 425 casos. Las principales causas de cirrosis fueron NASH (66.4%), alcohol (26.1%) y hepatitis viral (4%). El 17.6% se encontró en fase compensada al momento del diagnóstico. En la muestra estudiada, la sobrevida global fue del 23.7%. La mediana de sobrevida global fue de ocho y tres años, según se presente en fase compensada y descompensada al momento del diagnóstico. Un bajo índice de Karnosfky y encontrarse en fase descompensada al momento del diagnóstico fueron factores de mal pronóstico. Conclusión: En un nosocomio referente del Ecuador, la principal causa de la cirrosis hepática fue NASH, seguido de alcohol. La mayoría de los pacientes fueron diagnosticados en fase descompensada, un importante factor de mal pronóstico. La sobrevida global es semejante a la descrita en estudios foráneos.
Background: There is little consensus regarding overall survival and associated factors among individuals with liver cirrhosis of different compensatory phases and etiologies. On the other hand, the vast majority of these studies come from Anglo-Saxon or European populations. At the moment there is little updated literature on patients from Latin America, especially from Ecuador. Objective: To establish the factors associated with overall survival in patients with liver cirrhosis treated in a reference hospital in the city of Guayaquil - Ecuador between January 2016 and December 2020. Methodology: Observational, analytical, prospective longitudinal study, retrospective recovery , of the historical cohort type. It will be carried out at the Teodoro Maldonado Carbo Hospital (HTMC), between January 2016 and December 2020. It will be carried out in patients with an established diagnosis of liver cirrhosis based on clinical, laboratory (eg thrombocytopenia), ultrasound findings. (eg: decreased liver size, splenomegaly) and/or endoscopic (esophageal varices); of any etiology. The different study variables will be retrieved from the computer system and individual medical records of the host hospital (HTMC). The information will be stored in an electronic, encrypted and online spreadsheet, compatible with MS Access. Results: 425 cases were recovered. The main causes of cirrhosis were NASH (66.4%), alcohol (26.1%), and viral hepatitis (4%). 17.6% were in a compensated phase at the time of diagnosis. In the sample studied, overall survival was 23.7%. The median overall survival was eight and three years, depending on whether it was in the compensated or decompensated phase at the time of diagnosis. A low Karnosfky index and being in a decompensated phase at the time of diagnosis were poor prognostic factors. Conclusion: In a reference hospital in Ecuador, the main cause of liver cirrhosis was NASH, followed by alcohol. Most of the patients were diagnosed in the decompensated phase, an important factor of poor prognosis. Overall survival is similar to that described in foreign studies.
Background: There is little consensus regarding overall survival and associated factors among individuals with liver cirrhosis of different compensatory phases and etiologies. On the other hand, the vast majority of these studies come from Anglo-Saxon or European populations. At the moment there is little updated literature on patients from Latin America, especially from Ecuador. Objective: To establish the factors associated with overall survival in patients with liver cirrhosis treated in a reference hospital in the city of Guayaquil - Ecuador between January 2016 and December 2020. Methodology: Observational, analytical, prospective longitudinal study, retrospective recovery , of the historical cohort type. It will be carried out at the Teodoro Maldonado Carbo Hospital (HTMC), between January 2016 and December 2020. It will be carried out in patients with an established diagnosis of liver cirrhosis based on clinical, laboratory (eg thrombocytopenia), ultrasound findings. (eg: decreased liver size, splenomegaly) and/or endoscopic (esophageal varices); of any etiology. The different study variables will be retrieved from the computer system and individual medical records of the host hospital (HTMC). The information will be stored in an electronic, encrypted and online spreadsheet, compatible with MS Access. Results: 425 cases were recovered. The main causes of cirrhosis were NASH (66.4%), alcohol (26.1%), and viral hepatitis (4%). 17.6% were in a compensated phase at the time of diagnosis. In the sample studied, overall survival was 23.7%. The median overall survival was eight and three years, depending on whether it was in the compensated or decompensated phase at the time of diagnosis. A low Karnosfky index and being in a decompensated phase at the time of diagnosis were poor prognostic factors. Conclusion: In a reference hospital in Ecuador, the main cause of liver cirrhosis was NASH, followed by alcohol. Most of the patients were diagnosed in the decompensated phase, an important factor of poor prognosis. Overall survival is similar to that described in foreign studies.
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ESTUDIO RETROSPECTIVO, CIRROCIS HEPATICA, SUPERVIVENCIA, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR