Perfil epidemiológico de pacientes com ascite devido à hepatopatia.

Abstract

Ascites corresponds to the accumulation of free fluid of origin pathology in the peritoneal cavity, being the most common complication of cirrhosis liver and presenting a mortality rate of 44% in five years. The association American Institute for the Study of Liver Diseases recommends performing analysis of the ascitic fluid through abdominal paracentesis in order to look for spontaneous bacterial peritonitis (SBP). A value greater than or equal to 250 polymorphonuclear cells/mm3

in the absence of a secondary cause, defines SBP, which demonstrably increases the mortality of these patients even more. A Child-Pugh classification, the MELD scale, serum total bilirubin levels, prothrombin time and renal dysfunction are considered prognostic factors on survival, however studies related to the subject are scarce in Brazil. OBJECTIVES: To describe the clinical and epidemiological characteristics and determine the etiology, severity and prognosis of patients admitted to the ward of medical clinic at Hospital Universitário Alcides Carneiro (HUAC) with ascites due to liver disease. METHODS: Prospective, cross-sectional, observational study involving the population of Campina Grande and neighboring cities, developed in period from April 2014 to March 2015. RESULTS: 38 patients. Of these, 68.4% were men and 44.7% were between 41 and 60 years old, being the majority brown and white (39.5% each). The main etiology of disease liver was alcoholism, with 65.8%, followed by viral hepatitis (hepatitis C, 5.3%; and hepatitis B, 2.6%). In the evolution of patients with study of the liquid ascites, 13.6% were diagnosed with SBP. On the Child-Pugh scale, 3.1% were class A; 43.8% class B; and 53.1% class C. According to the MELD score, 60.6% presented a value lower than 20. As for isolated laboratory markers, 63.0% had serum albumin equal to or greater than 2.5 g/dL and 25% had creatinine greater than or equal to 1.5 mg/dL. CONCLUSION: There was a predominance of male patients with a mean age of 58 years. The main etiology for decompensated cirrhosis with ascites was alcoholism. this complication was associated with high morbidity and mortality, especially when related to worse prognostic factors, such as high Child and MELD.