title: Decompensated cirrhosis-related admissions in a large urban hospital in Uganda: prevalence, clinical and laboratory features and implications for planning patient management.
abstract: BACKGROUND
  Cirrhosis-related complications are a major cause of morbidity and mortality in areas where its risk factors are endemic.
  
  
  OBJECTIVE
  We determined the prevalence of decompensated cirrhosis among patients on the gastroenterology service of Mulago Hospital and described the clinical and laboratory features of these patients.
  
  
  METHODS
  All patients admitted to the unit were assessed and their diagnosis documented. Patients with cirrhosis had clinical features of decompensation recorded. History of alcohol consumption was taken and testing for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) performed.
  
  
  RESULTS
  Between September 2010 and January 2011, we enrolled 482 patients. The majority (53.7%) were male, overall median age 38 years. Decompensated cirrhosis was diagnosed in 85 (17.6%) patients. Of the 85 patients, 47 (55.3%) gave a history of alcohol intake, HBsAg was positive in 23 (27.1%) and anti-HCV in 3 (3.5%). Decompensation was defined by ascites among 81 (95.3%) patients, variceal bleeding in 31 (36.5%), encephalopathy in 20 (23.5%).
  
  
  CONCLUSIONS
  Cirrhosis is common in Mulago hospital presenting mainly with ascites and variceal bleeding. Aside from controlling causes of liver diseases, especially alcohol and hepatitis B virus infection, in the interim it is necessary to manage complications in patients who already have cirrhosis.
authors.affiliation: Department of Medicine, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: B S
authors.initials: BS
authors.lastname: Apica
authors.affiliation: Department of Medicine, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: P
authors.initials: P
authors.lastname: Ocama
authors.affiliation: Department of Medicine, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: E
authors.initials: E
authors.lastname: Seremba
authors.affiliation: Department of Medicine, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: K C
authors.initials: KC
authors.lastname: Opio
authors.affiliation: Department of Medicine, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: M M
authors.initials: MM
authors.lastname: Kagimu
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult