Sociodemographic Profile, Clinical Characteristics and Mortality Predictors of Inpatients with Liver Cirrhosis: A Study from a Teaching Hospital in Ghana
Sociodemographic Profile, Clinical Characteristics and Mortality Predictors of Inpatients with Liver Cirrhosis: A Study from a Teaching Hospital in Ghana
Document Type : Scientific Research
Authors
1 Internal Medicine Department, Ho Teaching Hospital, Ho, Volta Region, Ghana
2 Princess Marie Children Hospital, Accra, Greater Accra Region, Ghana
3 School of Medicine, University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana
4 University of Health and Allied Sciences, School of Medicine, PMB 31, Ho, Volta Region, Ghana
Abstract
Patients & Methods: A retrospective study was conducted among adult patients admitted with liver cirrhosis between January 2020 and December 2024. Cirrhosis was diagnosed based on a composite of clinical features (ascites, spider nevi, palmar erythema, splenomegaly), biochemical abnormalities (hypoalbuminemia, prolonged INR, hyperbilirubinemia), and radiological findings (nodular and/or shrunken liver). Etiology was assigned based on documented viral serology and alcohol history. Data were extracted from patient records and analyzed using SPSS version 26. Descriptive statistics summarized patient characteristics. Associations with mortality were assessed using chi-square tests, and multivariate logistic regression was used to identify independent predictors of in-hospital mortality, with p < 0.05 considered statistically significant.
Results: A total of 144 patients were included; 73.6% were male, with a mean age of 52 years. Alcohol was the most common etiology, followed by hepatitis B. About 53.5% presented with Child-Pugh class C disease. Ascites and jaundice were the most frequent clinical features. The overall in-hospital mortality rate was 20.1%. Upper gastrointestinal bleeding and hepatocellular carcinoma were independent predictors of mortality.
Conclusion: Liver cirrhosis patients at HTH commonly present with advanced disease and experience significant in-hospital mortality. Early diagnosis, improved endoscopic care, and enhanced hepatocellular carcinoma surveillance may improve outcomes.
What You Need to Know
BACKGROUND & CONTEXT: Sub-Saharan Africa carries a high burden of liver cirrhosis, but clinical profiles and outcomes outside major tertiary referral centers remain underreported.
NEW FINDINGS: In this Ghanaian inpatient cohort, alcohol consumption was the leading cause of cirrhosis (68.8%), surpassing Hepatitis B. Overall in-hospital mortality was 20.1%, independently predicted by Hepatocellular Carcinoma (aOR = 5.03) and Upper GI Bleeding (aOR = 3.74).
CLINICAL IMPLICATIONS: Highlights a regional shift toward alcohol-driven liver disease and stresses the urgent need for expanded viral hepatitis screening, rapid endoscopic bleeding control, and routine early HCC surveillance.
GRAPHICAL ABSTRACT / VISUAL SYNOPSIS
20.1%
In-Hospital Mortality
53.5% presented in Child-Pugh Class C
68.8%
Alcohol-Related Etiology
Predominant cause, surpassing HBV (27.1%)
Independent Risk Factors
• HCC (aOR = 5.03, p = 0.011)
• Upper GI Bleed (aOR = 3.74, p = 0.012)
Comments