Factors associated with death and duration of stay of cirrhotic patients admitted in the hepato-gastroenterology unit of Lomé Campus Teaching Hospital (Togo)

Abstract

Background: In Togo, the death rate for cirrhosis was estimated at 33.4%. The purpose of this study was to identify the factors associated with the duration of stay and death of cirrhotic patients hospitalized in the hepato-gastroenterology department.

Patients and method: A retrospective, descriptive and analytical cross-sectional study was conducted from January 1, 2005 to December 31, 2014 in the Hepato-gastroenterology unit of the Teaching Hospital of Lomé. In-patient records during the study period for cirrhosis and its complications were included. The probability of survival was determined by the Kaplan-Meier method.

Results: We enrolled 2152 hospitalized cirrhotic patients during the study period, including 1447 men (67.2%) and 705 women (32.8%). The median age was 48 years. There were 567 deceased patients (26.3%). The median duration of stay was 7 days. Death occurred in 64.4% of cases in the first week of hospitalization (p <0.001). Hepatocellular carcinoma, oedemato-ascitic decompensation, jaundice and gastrointestinal bleeding were the complications significantly associated with death. The Child-Plugh-Turcott C score was significantly associated with death (p < 0.001). In the event of death, the median duration of stay was 1.5 days for patients with hepatic encephalopathy; it was 6 days in case of ascites. The probability of overall survival at the first day of hospitalization was 94.1%; it decreasedto 23% by the 40th day. Survival was significantly associated with the
Child Plugh Turcott score (p < 0.001). Hepatic encephalopathy had a 5.2-fold higher risk of death than oedemato-ascitic decompensation.

Conclusion: The majority of cirrhotic patients hospitalized a Child Pugh score stages B and C; more than half of the deaths occurred in the first week of hospitalization.

Keywords: Cirrhosis, Death, Survival, Togo