Research Article - Journal of Gastroenterology and Digestive Diseases (2025) Volume 10, Issue 4

Epidemiological, diagnostic and evolutionary aspects of decompensated cirrhosis in patients hospitalized in an overseas hepato-gastroenterology department.

Introduction: The lack of data on decompensated cirrhosis in our overseas departments has motivated the realization of this work, which aims to describe the epidemiological aspects, diagnosis and evolution of decompensated cirrhosis within a Hepato-Gastroenterology Department of CHU of Guadeloupe.

Materials and methods: This is a single-center retrospective study from 01/01/2020 to 12/31/2023. Data were collected from the Electronic Medical Record (EMR) and cases identified at from ICD-10 codes. We included all hospitalizations for acute decompensation on cirrhosis (ascites, digestive hemorrhage, hepatic encephalopathy, infection). Excluded were: Hospitalizations for paracentesis in the context of refractory ascites and hepatic complications acute on chronic non-cirrhotic liver disease.

Results: For 437 hospitalizations, we collected 157 patients. Among the 157 patients we collected data from 236 hospitalizations with acute decompensation due to readmission of patients with new cases. The mean age of patients (N=157) was 63 years (± 11.7 years) with a male predominance of 79.6% and a sex ratio of 4 men/women. Etiologies of cirrhosis were dominated by alcoholism (59.2%), the association alcohol+MASH (8.9%) followed by MASH (5.7%), Alcohol+HBV (4.5%) for 3.2% of patients, no cause was established. Among the 236 hospitalizations, 91.1% had simple decompensation versus 8.9% (n=21) with Acute-on- Chronic Liver Failure (ACLF) criteria. The most common decompensation was ascites (76.1%), followed by digestive hemorrhage (15.9%) and hepatic encephalopathy (12.5%). Decompensation factors were acute alcoholic hepatitis (31.7%), infection (26.6%), iatrogenic (9.5%) and therapeutic interruption (6.3%). Decompensated cirrhosis was aggravated by portal thrombosis in 26.2% of cases, hepatocellular carcinoma (25.4%), and hepatorenal syndrome (12.2%). The majority of patients without ACLF had a Child-Pugh score B (50.4%). The mean MELD score was 18.6 ± 8.6. Among the 157 patients we recorded 23% (n=36) of deaths, related to ACLF in 38.8% of cases and to simple decompensation in 61.2% in connection with a metastatic hepatocellular carcinoma (27.8%), bacterial infection (16.7%), hemorrhage digestive (11.1%) or hepatic encephalopathy (5.6%).

Conclusion: Decompensated cirrhosis occurs mainly in the context of alcoholic disease of the liver. Its prognosis remains poor in our departments and justifies the implementation of a strategy prevention and management of alcoholic liver disease.

Author(s):

Marie Zogbo-Beavogui*, Nathaniel Edery, Estelle Urbanek, Marion Wallyn, Marie Sautereau, Zoe Labat, Marceline Alexis, Georgette Saint-Georges, Leonardo Amaral, Moana Gelu-Simeon

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