Retrospective, single-center evaluation of liver cirrhosis cases in a geriatric population

Year 2020, Volume: 34 Issue: 2, 93 - 101, 31.08.2020

Aslı Kılavuz Ferit Çelik Nalan Gülşen Ünal Ali Şenkaya Seymur Aslanov Sumru Savaş Fatih Tekin Ahmet Ömer Özütemiz

https://doi.org/10.5505/deutfd.2020.65365

Abstract

INTRODUCTION: Since there is insufficient epidemiological data on liver cirrhosis, especially in the elderly population of many countries, we aimed to evaluate geriatric cases with liver cirrhosis hospitalized at our gastroenterology clinic, retrospectively.
METHODS: The study included 99 patients aged 65 years and over who were hospitalized with liver cirrhosis in Ege University Faculty of Medicine, department of gastroenterology. The socio-demographic, clinical and laboratory data were recorded from the patient files.
RESULTS: In total, 99 elderly patients (mean age 71.7 ± 5.2 years; 59% male) were included. Hepatocellular carcinoma was statistically significantly correlated with etiology, presence of ascites, the Model of End-Stage Liver Disease score and the Child-Turcotte-Pugh score (p = 0.003, p = 0.009, p = 0.033, p = 0.003, respectively). The presence of esophageal varices was statistically significantly correlated with class and scores of the Child-Turcotte-Pugh, total bilirubin, Model of End-Stage Liver Disease score and the presence of ascites (p < 0.0001, p = 0.001, p = 0.011, p = 0.004, p = 0.004, respectively).
DISCUSSION AND CONCLUSION: The main etiology of liver cirrhosis was Hepatitis C virus, which accounted for almost one-third of the cirrhotic elderly inpatients at the gastroenterology department. Hepatocellular carsinoma was the leading cause of hospitalization. Elderly patients with liver cirrhosis should be carefully evaluated for cirrhosis complications. The Child-Turcotte-Pugh classification and Model of End-Stage Liver Disease scoring should be undertaken, and the suitability for liver transplantation should be considered in the follow-up and treatment of this patients.

Keywords

liver cirrhosis, elderly, hepatocellular carcinoma

Geriatrik popülasyonda karaciğer sirozlu olguların retrospektif, tek merkezli değerlendirilmesi

Abstract

GİRİŞ ve AMAÇ: Birçok ülkenin yaşlı popülasyonunda karaciğer sirozu hakkında yeterli epidemiyolojik veri olmadığı için gastroenteroloji kliniğimizde yatan karaciğer sirozu tanılı geriatrik olguların retrospektif olarak değerlendirilmesi amaçlandı.
YÖNTEM ve GEREÇLER: Çalışmaya Ege Üniversitesi Tıp Fakültesi Gastroenteroloji kliniğinde yatmış 65 yaş ve üzeri karaciğer sirozu tanılı 99 hasta dahil edildi. Hasta dosyalarından sosyodemografik, klinik ve laboratuvar verileri kaydedilmiştir.
BULGULAR: Çalışmaya dahil edilen 99 yaşlı hastanın yaş ortalaması 71.7 ± 5,2 yıl, % 59’u erkek idi. Hepatoselüler karsinom ile etiyoloji, asit varlığı, Model of End-Stage Liver Disease skoru ve Child-Turcotte-Pugh skoru arasında istatistiksel olarak anlamlı ilişki saptanmıştır (sırasıyla, p = 0,003, p = 0,009, p = 0,033, p = 0,003). Özofagus varisi varlığı ile Child-Turcotte-Pugh sınıfı ve skoru, total bilirubin, Model of End-Stage Liver Disease skoru ve asit varlığı arasında istatistiksel olarak anlamlı ilişki saptanmıştır (sırasıyla, p <0.0001, p = 0,001, p = 0,011, p = 0,004, p = 0,004).
TARTIŞMA ve SONUÇ: Gastroenteroloji kliniğimizde yatan yaşlılarda karaciğer sirozunun ana etiyolojisi Hepatit C virüsü olup sirotik popülasyonun neredeyse üçte birini oluşturmaktadır. Hastaneye yatış nedenleri arasında ilk sırada hepatoselüler karsinom yer almaktadır. Karaciğer sirozu tanısıyla hastaneye yatırılan yaşlılar siroz komplikasyonları açısından dikkatle değerlendirilmeli, Child-Turcotte-Pugh ve Model of End-Stage Liver Disease skorlaması yapılarak, özellikle karaciğer nakli açısından uygunlukları da göz önünde bulundurularak takip ve tedavi edilmelidir.

Keywords

karaciğer sirozu, yaşlı, hepatosellüler karsinom

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