title: Retrospective study of the clinical profile and prognostic indicators in patients of alcoholic liver disease admitted to a tertiary care teaching hospital in Western Nepal.
abstract: OBJECTIVE
  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.
  
  
  OBJECTIVE
  To study the demographic profile, laboratory parameters, complications and their prognostic implications among patients of alcoholic liver disease (ALD).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Manipal Teaching Hospital, Pokhara, Nepal. pathakomkrishna@yahoo.com
authors.forename: Om K
authors.initials: OK
authors.lastname: Pathak
authors.forename: Raju
authors.initials: R
authors.lastname: Paudel
authors.forename: Om B
authors.initials: OB
authors.lastname: Panta
authors.forename: Hom P
authors.initials: HP
authors.lastname: Pant
authors.forename: Bishnu R
authors.initials: BR
authors.lastname: Giri
authors.forename: Baikuntha
authors.initials: B
authors.lastname: Adhikari
mesh_terms: D000328:Adult; D017677:Age Distribution; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution