Clinical Features of Refractory Ascites in Outpatients
OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month. RESULTS: The most common etiology of cirrhosis in both groups was alcoholism [49 refractory (R) and 11 non-refractory ascites (NR)]. The majority of patients in the refractory group had Child-Pugh class B cirrhosis (p=0.034). The nutritional assessment showed protein-energy malnutrition in 81.6% of the patients in the R group and 35.5% of the patients in the NR group, while hepatic encephalopathy, hernia, spontaneous bacterial peritonitis, upper digestive hemorrhage and type 2 hepatorenal syndrome were present in 51%, 44.9%, 38.8%, 38.8% and 26.5% of the patients in the R group and 9.1%, 18.2%, 0%, 0% and 0% of the patients in the NR group, respectively (p=0.016, p=0.173, p=0.012, p=0.012, and p=0.100, respectively). Mortality occurred in 28.6% of the patients in the R group and in 9.1% of the patients in the NR group (p=0.262). CONCLUSION: Patients with refractory ascites were malnourished, suffered from hernias, had a high prevalence of complications and had a high postoperative death frequency, which was mostly due to infectious processes.
Main Authors: | Caly,Wanda Regina, Abreu,Rodrigo Martins, Bitelman,Bernardo, Carrilho,Flair José, Ono,Suzane Kioko |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Faculdade de Medicina / USP
2017
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000700405 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Similar Items
-
Refractory ascites and graft dysfunction in early renal transplantation
by: Eusébio,Catarina Pereira, et al.
Published: (2019) -
Clinical pharmacology profile of care in Hepatology clinic
by: Passos,Talita Rocha, et al.
Published: (2017) -
Hepatitis C: facts in numbers
by: Ono-Nita,Suzane Kioko, et al.
Published: (2006) -
Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic
by: Vale,Francisco A.C., et al.
Published: (2002) -
Clinical features and chromosomal abnormality in Myelodysplastic Syndrome of the Refractory Anaemia Subtype
by: Ortega,Manoela M., et al.
Published: (2004)