Management and outcomes of hepatic cirrhosis: Findings from the RING study.
OBJECTIVE
Hepatic cirrhosis is a frequent reason for ordinary hospital admission (OA). The RING study collected hospital discharge files (HDF) from Italian hospital gastroenterology units (IGU). This caselist provides a broad picture of the patients admitted for this pathology.


METHODS
More than 50,000 HDF for OA were collected between 2001 and 2004 from 26 IGU.


RESULTS
Eight thousand four hundred and eighty-seven HDF (16%) had a diagnosis of hepatic cirrhosis; Child-Pugh classes were 20.2% A, 34.8% B and 45.0% C. Patients' mean age was 63.7+/-12.1 years and 62.5% were male. A 61.1% of the cirrhosis cases had ascites, 29.9% portal-systemic encephalopathy, 29.2% hepatocellular carcinoma (HCC), 10% bleeding varices, 3.0% hepatorenal syndrome (HRS). Mortality for OA for cirrhosis was 5.7% versus 2.6% for other diagnoses. The proportion varied with the severity of the cirrhosis: 0% for Child A, 1.1% B, 10.5% C. Mortality was significantly associated with: Child-Pugh at admission (odds ratio: OR 9.2), HRS (OR 11.7), bleeding varices (OR 2.2), HCC (OR 1.8).


CONCLUSIONS
Hepatic cirrhosis was found in 16% of the OA to IGU and mortality was double the rate for all the other pathologies in the same wards. Child-Pugh is a useful prognostic tool, higher classes implying a greater risk of death. HRS and bleeding varices were the complications with most influence on in-hospital mortality.
Soncini
M
M
Gastroenterology, S. Carlo Borromeo Hospital, Via Pio II 3, 20153 Milano, Italy.
Leo
P
P
Triossi
O
O
Breda
C
C
Attili
A F
AF
Mondardini
A
A
Federico
A
A
Cosentini
A
A
Tritto
G
G
Bottelli
R
R
Pompeo
F
F
Marone
G P
GP
Bonazzi
P
P
Magnolia
M R
MR
Pietrini
L
L
Proietti
M
M
Belfiori
V
V
Tozzi
A
A
Giglio
L A
LA
Muratori
R
R
Bertelè
A M
AM
Grasso
T
T
Spadaccini
A
A
Verta
M
M
Ferraris
L
L
Caruso
S
S
Sega
R
R
Brambilla
G
G