RESUMO
BACKGROUND/AIM: Alcohol is the most common substance abused in Nepal. Liver disease caused by alcohol abuse, including its end stage, cirrhosis, is a major health care problem, which is difficult to treat. OBJECTIVES: To study the demographic profile, laboratory parameters, complications and their prognostic implications among patients of alcoholic liver disease (ALD). MATERIALS AND METHODS: Records of all patients of ALD admitted from January1 , 2005 to December 31 , 2006 were studied and followed up to December 31, 2007. A total of 181 patients were analyzed. Their clinical profile and laboratory parameters were noted and analyzed using SPSS-10.0 software. RESULTS: Among the 181 patients, 80.7% were male, 30.9% were army/ex-army and 65.2% were documented smokers. The mean age of presentation was 52.08 years. Jaundice (57.5%) was the most common presentation followed by hepatomegaly (51.4%). Hypoalbuminemia (50.3) followed by ascites (48.1) were common complications. Death occurred in 19.1% of the patients, the most common cause being hepatic encephalopathy (72.2%) followed by variceal bleeding and hepatorenal syndrome. Jaundice, ascites and hepatic encephalopathy at presentation and female sex were significantly associated with increased mortality along with discriminant score > 32, aspartate aminotransferase (AST): Alanine aminotranferase (ALT) > or = 2, ultrasonography (USG)-proven cirrhosis, rise in prothrombin time > or =5 s, total bilirubin > or = 4 mg/dL and ESR > or =34. CONCLUSION: ALD was predominantly seen among the productive age group with a high morbidity and mortality. Jaundice, ascites, hepatic encephalopathy at presentation and female sex are poor prognostic indicators along with discriminant score > 32, AST:ALT > or = 2, USG-proven cirrhosis, coagulopathy, hyperbilirubenemia and high ESR.
