Dataset Information

Short-term clinical outcomes of patients admitted with chronic liver disease to selected teaching hospitals in Ethiopia.

ABSTRACT:

Background

Chronic liver disease (CLD) is a progressive destruction of liver tissue with subsequent necrosis that persists for at least 6 months. In Ethiopia, despite the high burden report, data on CLD is limited. The objective of this study was to assess short-term clinical outcomes in patients admitted with chronic liver disease to three tertiary teaching hospitals in Ethiopia and to identify predictors of mortality.

Methods

A cohort of 109 patients admitted with CLD to three tertiary teaching hospitals in Ethiopia, were prospectively followed from the time of admission to 30-days of hospital discharge. The study was conducted from April 1, 2018, to October 5, 2018. Kaplan-Maier curve was used to estimate survival and cox-regression analysis to identify predictors of mortality.

Result

A total of 109 patients (80% male) diagnosed with CLD were included. Median age of the participants was 38(IQR, 30-48). The overall median length of hospital stay was 7(IQR, 4-11) days. Of the total, 39(35.8%) patients were HBsAg positive, and 12(11%) patients were anti-HCV positive. The 30-day mortality was 38(34.9%), and most of the deaths, 31(81.6%) occurred before hospital discharge. Hepatic encephalopathy at admission; being with unidentified risk factor/etiologies of CLD and total bilirubin level were independent predictors of in-hospital mortality. Patients with hepatic encephalopathy at admission had approximately 11 times increased risk of death as compared to patients without hepatic encephalopathy at admission. Similarly, the hazard of mortality was 5.8 times higher in those patients with unidentified risk factor/etiology as compared to others. The risk of dying had also increased with an increase in bilirubin (1.188[95% CI, 1.0719-1.316]) level.

Conclusion

Approximately one-quarter of patients with CLD died during their hospital stay, and the risk of death continued after hospital discharge. Hepatic encephalopathy at admission, unidentified risk factor/etiology and increased level of total bilirubin are poor prognostic factors. Given that more than one third the patients had HBV-infection, access to antiviral drugs could help improve the prognosis of patients with end-stage liver disease in Ethiopia, as well as prevent the progression of the disease if initiated earlier.

SUBMITTER: Terefe Tesfaye B

PROVIDER: S-EPMC6716656 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Short-term clinical outcomes of patients admitted with chronic liver disease to selected teaching hospitals in Ethiopia.

Terefe Tesfaye Behailu B Gudina Esayas Kebede EK Bosho Dula Dessalegn DD Mega Teshale Ayele TA

PloS one 20190830 8

<h4>Background</h4>Chronic liver disease (CLD) is a progressive destruction of liver tissue with subsequent necrosis that persists for at least 6 months. In Ethiopia, despite the high burden report, data on CLD is limited. The objective of this study was to assess short-term clinical outcomes in patients admitted with chronic liver disease to three tertiary teaching hospitals in Ethiopia and to identify predictors of mortality.<h4>Methods</h4>A cohort of 109 patients admitted with CLD to three t ...[more]

PMID: 31469861

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Project description:BackgroundIn meeting the global standard of patient safety, quality care and nursing leadership, countries are urged by the World Health Organisation to have a greater proportion of nurses educated to degree level or higher. However, some researchers have found that there are very little differences in competencies of diploma registered nurses and first degree nurses in some countries. University education in nursing remains problematic and there are many disparities in the programmes currently being offered in different parts of the world. Though teaching hospitals in Ghana are expected to assist in the training of undergraduate nursing students, there is limited scientific evidence on experiences of undergraduate nursing students in these teaching hospital environments. The purpose of this study was to explore the experiences of undergraduate nursing students in selected teaching hospitals in Ghana.MethodsA qualitative explorative descriptive design was used in conducting the study. Purposive sampling technique was utilised in collecting data from thirty-five undergraduate nursing students placed in two teaching hospitals in Ghana. Data were collected through a semi-structured interview guide and analysed manually by the research team. A thematic content analysis was used in analysing data.ResultsFour main categories of themes were extracted from data. These themes were: 1. Feeling isolated in clinical placement. 2. Inadequate application of the nursing process. 3. Encounter with complex medical devices and complex conditions. 4. Inadequate application of physical examination by nurses.ConclusionThere were both positive and negative experiences by undergraduate nursing students in teaching hospitals in Ghana. The opportunity to see various clinical cases and also use complex medical devices were positive experiences for students. However, the undergraduate nursing students also experienced challenges of isolation in placement, inadequate application of the nursing process, and inadequate application of physical assessment by nurses. Undergraduate nursing students require varying levels of support, supervisory commitments and logistics provisions to learn skills such as physical examination and nursing process during placement.

Dataset Information

Short-term clinical outcomes of patients admitted with chronic liver disease to selected teaching hospitals in Ethiopia.

Background

Methods

Result

Conclusion

Publications

Short-term clinical outcomes of patients admitted with chronic liver disease to selected teaching hospitals in Ethiopia.

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