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192015

Role of Portal Hemodynamics in Mortality and Adverse Out-come Prediction of Hyponatremic Cirrhotic Patients

Article

Last updated: 22 Jan 2023

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Tags

Clinical Research (Medical)

Abstract

Background: Cirrhotic patients have variable degrees of hepatic dysfunction. Impaired portal hemodynamics and hyponatremia occurs in the setting of end-stage liver disease. Aim: to uncover the role of portal hemodynamics in mortality and adverse outcome prediction of hyponatremic cirrhotic patients. Subjects and Methods:Eighty cirrhotic patients with hyponatremia (serum Na<130mmol/L) were included. ]iagnosis of hepatic encephalopathy using West Haven criteria, laboratory investigations, modified Child-Pugh and MELD scores were calculated, abdominal ultrasonography with Doppler study of portal circulation and upper GIT endoscopy were performed and the patients were followed up during their stay in hospital. Results:Serum sodium level has high statistically significant negative correlation with modified Child-Pugh score (P <0.001) and with MELD score (P <0.001). Most of the patients developed hepatic encephalopathy, spontaneous bacterial peritonitis, hepato-renal syndrome, and bleeding recorded in some patients; meanwhile mortality in 10% of the patients. In addition, apart from Hepatic Artery resistive Index, the difference in MELD score, MELD-Na score and Portal vein congestive Index between non-survived and survived patients was statistically insignificant, although all these indices were highly significant with hepatic encephalopathy, Portal vein congestive Index is highly significant in hepatorenal syndrome and bleeding esophageal varices, and Hepatic Artery resistive Index is highly significant in hepatorenal syndrome. Analysis of the receiver operating characteristic curve revealed that Portal vein CI was the most sensitive indicator (sensitivity 78.5%) and hepatic A resistive Index was the most specific indicator for prediction of mortality in hyponatremia cirrhotic patients. Conclusion:portal vein CI and hepatic A. RI can be used in the prediction of mortality in hyponatremia cirrhotic patients.
 

DOI

10.21608/scumj.2021.192015

Keywords

Hyponatremia, Portal hemodynamics, Portal vein congestive Index

Authors

First Name

Nagla

Last Name

Abd Al Monem

MiddleName

-

Affiliation

Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt

Email

drnaglahyh@yahoo.com

City

-

Orcid

-

First Name

Samir

Last Name

Afifi

MiddleName

A

Affiliation

Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt

Email

drsamir_2007@yahoo.com

City

-

Orcid

-

First Name

Samar

Last Name

Ahmed

MiddleName

S

Affiliation

Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Suez University, Egypt

Email

-

City

-

Orcid

-

First Name

Dalia

Last Name

Ghareeb

MiddleName

-

Affiliation

Department of Clinical Pathology, Faculty of Medicine, Suez University, Egypt

Email

daliaghareeb13@yahoo.com

City

-

Orcid

-

First Name

Rehab M.

Last Name

Ateya

MiddleName

M

Affiliation

Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt

Email

-

City

-

Orcid

-

First Name

Ahmed

Last Name

Bessar

MiddleName

A

Affiliation

Department of Radio-diagnosis, Faculty of Medicine, Zagazig University, Egypt

Email

-

City

-

Orcid

-

First Name

Fatma

Last Name

Rageh

MiddleName

-

Affiliation

Department of Infectious diseases, Gastroenterology and Hepatology, Faculty of Medicine, Suez University

Email

frageh2002@hotmail.com

City

Suez

Orcid

-

Volume

24

Article Issue

2

Related Issue

27374

Issue Date

2021-10-01

Receive Date

2021-08-30

Publish Date

2021-10-01

Page Start

118

Page End

127

Print ISSN

1110-6999

Online ISSN

2090-2581

Article File

SCUMJ_Volume 24_Issue 2_Pages 118-127.pdf

PDF . 520.3kB

Link

https://scumj.journals.ekb.eg/article_192015.html

Detail API

https://scumj.journals.ekb.eg/service?article_code=192015

Order

4

Type

Original Article

Type Code

938

Publication Type

Journal

Publication Title

Suez Canal University Medical Journal

Publication Link

https://scumj.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023