Pattern and Prevalence of Different Complications of Liver Cirrhosis in Medical Intensive Care Unit of Zagazig University Hospitals

Background: Cirrhosis is a common outcome of chronic liver disease (CLD). Research on the effects of liver cirrhosis complications in intensive care units (ICU) are still poor and inadequate in Egypt.
Objective: The aim of the present study was to determine pattern, prevalence, and prognostic significance of liver cirrhosis complications in ICU patients.
Patients and methods: The study included 303 patients with CLD at medical ICU in Zagazig university hospitals. All participants in this study were subjected to full history, thorough clinical examination, laboratory investigation, upper GIT endoscopy and radiological investigations. Assessment of liver disease severity including child-Pugh score and MELD score were performed. Deaths from complications of cirrhosis, progressive liver failure and hepatocellular carcinoma were considered to be liver related.
Results: The least frequent complication (3.3%) for CLD disease among the studied population was hepatorenal syndrome (HRS). Mortality rates were higher in patients with the age group of 63-73 years, in male patients and in those who were from rural areas. Higher levels of ALT, AST, PTT, INR, serum creatinine and BUN were associated with higher incidence of mortality. Coagulopathy and hyponatremia were the most common causes of death, followed by variceal bleeding and ascites. Length of hospital stay and fresh frozen plasma (FFP) transfusion, could predict the in-hospital mortality. Conclusion: CLD is a universal problem and considered as one of the most challenging health problem in Egypt. End-stage liver disease leads to a rise in morbidity and mortality. Coagulopathy was the most common complication for CLD. Length of hospital stay and FFP transfusion were good predictor for in-hospital mortality.