Jawgam Umbon1, Kalpana C2, Niranjan G3
Alcoholic Liver Disease (ALD) is a major cause of mortality and morbidity worldwide. ALD has varied clinical and biochemical presentation ranging from the subtle features of fatty liver to obvious findings of decompensated cirrhosis.
To study the clinical profile and their prognostic implications among patients of alcoholic liver disease.
MATERIALS AND METHODS
The study population included total 138 patients proven to have ALD on the basis of clinical, biochemical and ultrasonographic parameters admitted in Jorhat Medical College and Hospital, Jorhat (Assam), over a period of 1 year (July 2015 to June 2016).
Out of 138 patients (113 males and 25 females), majority of the patients were in the age group of 41-50 years (34.78%). The mean age of presentation was 45.91±10.34 years, with a male to female ratio of 4.5:1. The common clinical presentations were abdominal distension and swelling of feet (51.45%), jaundice (49.29%), Melaena/Haematemesis (29.72%) and altered sensorium (19.57%). The common clinical findings were pallor (62.32%), ascites (59%), pedal oedema (55.8%), icterus (54.35%), hepatomegaly (44.20%) and splenomegaly (36.96%). Features of hepatic encephalopathy were seen in 16% patients. The mean liver function test values were total bilirubin (6.59±6.61 mg/dL), albumin (2.46±0.7 g/dL), AST (155.61±85.24 U/L), ALT (81.65±37.59 U/L), ALP (150.59±66 U/L), GGTP (217.30±203.01 U/L) and PT (17.30±4.65 secs.). The mean platelet count was 125,421.7±65,910 /cu.mm and mean prolongation of PT was 5.37±5.02 secs. The average duration of alcohol intake in fatty liver, hepatitis and cirrhosis were 12.77±3.70, 14.56±6.83 and 20.53±6.08 years, respectively. A total of 21 (15.22%) patients expired during the hospital stay. Hepatic encephalopathy (42.86%) and hepatorenal syndromes (28.56%) were the major causes of death.
ALD patients had a longer duration of hospitalisation. Longer duration rather than the patterns of alcohol intake was associated with development of liver disease. Jaundice, ascites at presentation, hepatic encephalopathy, lower serum albumin, lower platelet count, AST/ALT ratio >2 and discriminant function >32 were found to be significantly associated with mortality.